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急性中耳炎患儿在12周的急性期过后,转成慢性渗出性中耳炎者占5～10%;大约1/3的中耳渗出液细菌培养阳性。为了探讨细菌对渗出性中耳炎的影响,对21例慢性渗出性中耳炎患儿的中耳渗出液中的溶菌酶、乳酸胆铁质(反映渗出液中多核白细胞活性)、补体C_3和C_(5a)、以及多核白细胞趋化因子的含量进行了测定。中耳液细菌培养,阳性者有流感嗜血杆菌、肺炎链球菌、卡他双球菌及表面葡萄球菌。慢性渗出性中耳炎的发病机制可能是:渗出液中的细菌或来自激活补体的白细胞趋化因子驱使白细胞进入中耳;白细胞脱颗粒,释放出溶菌酶,溶菌酶损伤中耳组织,中耳上皮细胞分泌增加,上皮下毛细血管通透性增加,中耳出现渗出液。21份渗出液标本测定结果表明,多核白细胞趋化因子的平均含量(0.81±0.25cm)明显高于对
Acute otitis media in children after 12 weeks of acute transition to chronic exudative otitis media accounted for 5 to 10%; about 1/3 of the middle ear exudate bacterial culture positive. In order to investigate the effect of bacteria on otitis media with exudative otitis media, 21 cases of chronic exudative otitis media in the middle ear exudate lysozyme, ferrochlora lactate (reflecting exudate polymorphonuclear leukocyte activity), complement C_3 and C_ (5a), and multicellular leukocyte chemokine levels were determined. Middle ear fluid bacterial culture, positive were Haemophilus influenzae, Streptococcus pneumoniae, catarrhalis and surface staphylococcus. The pathogenesis of chronic exudative otitis media may be: exudate bacteria or from activated complement of leukocyte chemotactic factor driven white blood cells into the middle ear; leukocyte degranulation, the release of lysozyme, lysozyme damage in the middle ear, middle ear Increased secretion of epithelial cells, increased permeability of epithelial capillaries, exudate in the middle ear. The results of 21 exudate samples showed that the average content of multicellular leukocyte chemokines (0.81 ± 0.25cm) was significantly higher than that of