儿童分泌性中耳炎积液理化性质与氧化应激相关酶表达水平相关性研究

doi:10.12372/jcp.2025.25e0833

临床儿科杂志 ›› 2025, Vol. 43 ›› Issue (12): 928-932.doi: 10.12372/jcp.2025.25e0833

儿童分泌性中耳炎积液理化性质与氧化应激相关酶表达水平相关性研究

田恩霞¹^,², 郭丽宁¹^,², 刘珊珊¹^,², 张杰¹^,²^,³()

1.国家儿童医学中心首都医科大学附属北京儿童医院耳鼻咽喉头颈外科（北京 100045）
2.儿童耳鼻咽喉头颈外科疾病北京市重点实验室（北京 100045）
3.郑州大学附属儿童医院（河南省儿童医院郑州儿童医院）耳鼻咽喉头颈外科河南省儿童睡眠呼吸疾病早期筛查与精准诊疗工程研究中心（河南郑州 450018）

收稿日期:2025-07-15 录用日期:2025-10-14 出版日期:2025-12-15 发布日期:2025-11-28
通讯作者: 张杰电子信箱：stzhangj@263.net
基金资助:
河南省重点研发专项(251111313700)

Study on the correlation between the physicochemical properties of effusion in otitis media with effusion and the expression levels of oxidative stress-related enzymes in children

TIAN Enxia¹^,², GUO Lining¹^,², LIU Shanshan¹^,², ZHANG Jie¹^,²^,³()

1. Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children′s Hospital, Capital Medical University, National Center for Children′s Health, Beijing 100045, China
2. Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, Beijing 100045, China
3. Department of Otorhinolaryngology Head and Neck Surgery, Children′s Hospital Affiliated to Zhengzhou University, Henan Children′s Hospital, Zhengzhou Children′s Hospital, Henan Province Engineering Research Center of Early Diagnosis and Precise Treatment of Sleep Disordered Breathing, Zhengzhou 450018, Henan, China

Received:2025-07-15 Accepted:2025-10-14 Published:2025-12-15 Online:2025-11-28

摘要/Abstract

摘要：

目的针对分泌性中耳炎（OME）中耳积液理化性质，探讨氧化应激在OME中病理生理作用，为OME病因学提供理论依据。方法收集2023年7月—2024年12月于耳鼻咽喉头颈外科住院行鼓膜置管的OME患儿的临床资料、耳内镜和听力学检查结果。检测中耳积液（术中收集）和血清（术前收集）中髓过氧化物酶（MPO）、过氧化氢酶（CAT）、丙二醛（MDA）浓度。根据中耳积液黏稠度、病程、听力损失程度进行分组，比较不同组间MPO、CAT、MDA浓度差异，以及中耳积液与血清标本中MPO、CAT、MDA浓度差异。结果纳入OME患儿53例，中位年龄5.6（1~13）岁，其中男32例、女21例；耳内镜检查均见鼓室内积液；术前平均气导纯音听阈均值（PTA）为（36.51±1.31）dB HL。黏稠中耳积液组中MPO、CAT浓度显著低于稀薄中耳积液组，MDA浓度显著高于稀薄中耳积液组，差异均有统计学意义（P<0.05）。比较10例OME患儿中耳积液与自身血清中氧化应激标志物的浓度水平，发现MPO、CAT、MDA浓度在中耳积液中的浓度均显著高于其自身血清中的水平，差异有统计学意义（P<0.001）。病程长短、听力损失程度与中耳积液MPO、CAT、MDA浓度无相关性（P>0.05）。结论中耳积液理化性质与氧化应激有关，中耳积液与血清中氧化应激表达存在差异，氧化应激可能参与OME发病机制。

关键词: 分泌性中耳炎, 氧化应激, 发病机制, 儿童

Abstract:

Objective To investigate the pathophysiological role of oxidative stress in otitis media with effusion (OME) based on the physical properties of middle ear effusion, and to provide a theoretical basis for the etiology of OME. Methods Clinical data, otoscopic findings, and audiological test results were collected from pediatric OME patients undergoing tympanostomy tube placement in the Department of Otolaryngology-Head and Neck Surgery between July 2023 and December 2024. Concentrations of myeloperoxidase (MPO), catalase (CAT), and malondialdehyde (MDA) were measured in both middle ear effusions (intraoperatively collected) and serum samples (preoperatively collected). Participants were grouped according to effusion viscosity, disease duration, and degree of hearing loss. Differences in MPO, CAT, and MDA levels were compared across groups, as well as between middle ear effusions and matched serum samples. Results A total of 53 pediatric OME patients were included, with a median age of 5.6 (1-13 ) years, including 32 boys and 21 girls. Otoscopic examination confirmed middle ear effusion in all cases. The preoperative average pure-tone air conduction threshold was (36.51±1.31) dB HL. The concentrations of MPO and CAT in the viscous middle ear effusion group were significantly lower than those in the thin middle ear effusion group, while the concentration of MDA was significantly higher than that in the thin middle ear effusion group. The differences were statistically significant (P<0.05). The concentration levels of oxidative stress markers in the middle ear effusion and their own serum of 10 children with OME were compared. It was found that the concentrations of MPO, CAT and MDA in the middle ear effusion were significantly higher than those in their own serum, and the difference was statistically significant (P<0.001). No correlation was found between disease duration or degree of hearing loss and the concentrations of MPO, CAT, or MDA in middle ear effusions (P>0.05). Conclusions The physicochemical properties of middle ear effusion are related to oxidative stress. There are differences in the expression of oxidative stress between middle ear effusion and serum, and oxidative stress may be involved in the pathogenesis of OME.

Key words: otitis media with effusion, oxidative stress, pathogenesis mechanism, child

中图分类号:

田恩霞, 郭丽宁, 刘珊珊, 张杰. 儿童分泌性中耳炎积液理化性质与氧化应激相关酶表达水平相关性研究[J]. 临床儿科杂志, 2025, 43(12): 928-932.

TIAN Enxia, GUO Lining, LIU Shanshan, ZHANG Jie. Study on the correlation between the physicochemical properties of effusion in otitis media with effusion and the expression levels of oxidative stress-related enzymes in children[J]. Journal of Clinical Pediatrics, 2025, 43(12): 928-932.

图/表 4

表1

表2

表3

表4

参考文献 17

[1]	中华耳鼻咽喉头颈外科杂志编辑委员会,中华医学会耳鼻咽喉头颈外科学分会小儿学组. 儿童分泌性中耳炎诊断和治疗指南(2021)[J]. 中华耳鼻咽喉头颈外科杂志, 2021, 56(6): 556-567.
	Editorial Board of Chinese Journal of Otorhinolaryngology Head and Neck Surgery, Subspecialty Group of Pediatrics. Guideline for the diagnosis and treatment of otitis media with effusion in children (2021)[J]. Zhonghua Erbiyanhou Toujing Waike Zazhi, 2021, 56(6): 556-567.
[2]	Garça MF, Aslan M, Tuna B, et al. Serum myeloperoxidase activity, total antioxidant capacity and nitric oxide levels in patients with chronic otitis media[J]. J Membr Biol, 2013, 246(7): 519-524. doi: 10.1007/s00232-013-9561-8
[3]	Abdelhafeez M, Mohamed NM. Correlation between serum interleukin-17 level and serum reactive oxygen species levels among children experiencing otitis media with effusion[J]. Int Arch Otorhinolaryngol, 2021, 25(4): e570-e574.
[4]	Lv YX, Zhao SP, Zhang JY, et al. Effect of orange peel essential oil on oxidative stress in AOM animals[J]. Int J Biol Macromol, 2012, 50(4): 1144-1150. doi: 10.1016/j.ijbiomac.2012.02.002
[5]	World Health Organization. World report on hearing[EB/OL]. 2021[2025-07-15]. https://www.who.int/publications/i/item/9789240020481.
[6]	Sadé J, Luntz M, Levy D. Middle ear gas composition and middle ear aeration[J]. Ann Otol Rhinol Laryngol, 1995, 104(5): 369-373. doi: 10.1177/000348949510400506
[7]	Clark JM, Brinson G, Newman MK, et al. An animal model for the study of genetic predisposition in the pathogenesis of middle ear inflammation[J]. Laryngoscope, 2000, 110(9): 1511-1515. pmid: 10983952
[8]	Zhang J, He J, Luo Y, et al. miR-210 regulates the inflammation of otitis media with effusion by inhibiting the expression of hypoxia-inducible factor (HIF)-1a [J]. Biochem Biophys Res Commun, 2021, 534: 401-407.
[9]	Zhou H, Chen ZB, Tian HQ, et al. Effects of hypoxia-inducible factor 1alpha on bone conduction impairment in otitis media with effusion[J]. Acta Otolaryngol, 2012, 132(9): 938-943. doi: 10.3109/00016489.2012.675085
[10]	Schachern PA, Kwon G, Briles DE, et al. Neutrophil extracellular traps and fibrin in otitis media: analysis of human and chinchilla temporal bones[J]. JAMA Otolaryngol Head Neck Surg, 2017, 143(10): 990-995. doi: 10.1001/jamaoto.2017.1320
[11]	Lin W, Chen H, Chen X, et al. The roles of neutrophil-derived myeloperoxidase (MPO) in diseases: the new progress[J]. Antioxidants (Basel), 2024, 13(1): 132.
[12]	Yariktas M, Doner F, Dogru H, et al. The role of free oxygen radicals on the development of otitis media with effusion[J]. Int J Pediatr Otorhinolaryngol, 2004, 68(7): 889-894. doi: 10.1016/j.ijporl.2004.02.002
[13]	Machlin LJ, Bendich A. Free radical tissue damage: protective role of antioxidant nutrients[J]. FASEB J, 1987, 1(6): 441-445. pmid: 3315807
[14]	Takoudes TG, Haddad J Jr. Evidence of oxygen free radical damage in human otitis media[J]. Otolaryngol Head Neck Surg, 1999, 120(5): 638-642. pmid: 10229586
[15]	刘珊珊, 刘薇, 张杰, 等. 固有免疫在分泌性中耳炎中的作用[J]. 中华耳鼻咽喉头颈外科杂志, 2021, 56(6): 674-679.
	Liu SS, Liu W, Zhang J, et al. Role of innate immunity in otitis media with effusion[J]. Zhonghua Erbiyanhou Toujing Waike, 2021, 56(6): 674-679.
[16]	Guo H, Li M, Xu LJ. Apigetrin treatment attenuates LPS-induced acute otitis media though suppressing inflammation and oxidative stress[J]. Biomed Pharmacother, 2019, 109: 1978-1987. doi: S0753-3322(18)31803-1 pmid: 30551453
[17]	Yang S, Wu Y, Cheng X, et al. Harnessing astaxanthin-loaded diselenium cross-linked apotransferrin nanoparticles for the treatment of secretory otitis media[J]. J Control Release, 2024, 365: 398-411. doi: 10.1016/j.jconrel.2023.11.040

项目	黏稠中耳积液组(n=37)	稀薄中耳积液组(n=32)	Z值	P
MPO/ng·mL^-1	171.97(117.23~255.06)	239.09(198.08~281.03)	2.78	0.005
MDA/ng·mL^-1	278.74(224.82~427.74)	187.31(151.03~239.44)	4.54	<0.001
CAT/pg·mL^-1	586.61(72.65~3 333.57)	2 268.16(923.54~3 583.43)	2.46	0.014

项目	中耳积液组(n=10)	血清组(n=10)	t值	P
MPO/ng·mL^-1	219.69±19.47	13.00±2.69	10.90	<0.001
MDA/ng·mL^-1	240.27±17.52	34.44±1.09	11.84	<0.001
CAT/pg·mL^-1	2 602.16±306.3	631.90±108.73	6.29	<0.001

项目	病程<6个月(n=43)	病程≥6个月(n=26)	Z值	P
MPO/ng·mL^-1	206.79(129.56~262.86)	226.26(171.52~345.28)	1.25	0.211
MDA/ng·mL^-1	232.33(185.88~350.16)	228.58(168.01~278.74)	1.33	0.185
CAT/pg·mL^-1	1 427.71(264.67~3 573.04)	2 352.61(585.12~3 565.12)	1.11	0.265

项目	PTA<35dB HL组(n=29)	PTA≥35 dB HL组(n=40)	Z值	P
MPO/ng·mL^-1	222.48(144.73~258.43)	202.31(137.8~338.1)	0.04	0.971
MDA/ng·mL^-1	217.05(164.68~278.74)	235.43(189.23~335.07)	1.23	0.220
CAT/pg·mL^-1	2 512.25(553.95~3 517.96)	984.07(342.02~3 768.97)	1.03	0.301

儿童分泌性中耳炎积液理化性质与氧化应激相关酶表达水平相关性研究

Study on the correlation between the physicochemical properties of effusion in otitis media with effusion and the expression levels of oxidative stress-related enzymes in children

RichHTML

PDF (PC)

赞

可视化

摘要/Abstract

引用本文

使用本文

图/表 4

参考文献 17

相关文章 15

Metrics

本文评价

推荐阅读 0

[1]	张未, 汪洋, 邓文华, 吴亚斌. 14例原发性纤毛运动障碍临床表现、纤毛结构及基因特点分析[J]. 临床儿科杂志, 2025, 43(9): 680-685.
[2]	项琳娟, 陈雪欣, 贾艳会, 吴宇航, 丛鑫, 李伟, 陈盈盈, 陈笋, 黄丽素. 儿童3型腺病毒肺炎预后影响因素分析[J]. 临床儿科杂志, 2025, 43(9): 686-691.
[3]	常亚, 周昀箐, 王纪文, 吴鸿雁, 羊芳菲, 孙丽娜. 儿童先天性肌强直治疗3例报道[J]. 临床儿科杂志, 2025, 43(9): 692-697.
[4]	汪洁, 吴彬, 张兰男, 陈开澜. 儿童肝脾T细胞淋巴瘤2例并文献复习[J]. 临床儿科杂志, 2025, 43(9): 698-704.
[5]	叶泽慧, 姜小丽. 西罗莫司治疗儿童弥漫性肺淋巴管瘤病1例报告[J]. 临床儿科杂志, 2025, 43(9): 705-709.
[6]	董素贞, 陈浩, 张志勇, 江帆. 低场强MRI在儿科和产前胎儿诊断领域中的应用[J]. 临床儿科杂志, 2025, 43(9): 710-715.
[7]	石小松, 傅世杰, 何小花, 吕辉, 陈厚杨, 陈茂琳, 陈捷. 福建省两地区百日咳鲍特菌抗原基因型特征及耐药性分析[J]. 临床儿科杂志, 2025, 43(8): 575-582.
[8]	裴培, 李伟华, 淮婉, 姚如恩, 葛禾佳, 王纪文, 王秀敏, 吉炜, 周昀箐, 贺影忠, 韩凤. ATP1A2 / ATP1A3基因变异患儿10例遗传学及临床特征分析[J]. 临床儿科杂志, 2025, 43(8): 590-597.
[9]	李鹤婷, 孙瑞迪, 江军. 儿童急性抗GQ1b抗体综合征的临床特点、预后及神经电生理特征[J]. 临床儿科杂志, 2025, 43(8): 604-609.
[10]	张成, 曹巧玉, 郑璐瑶, 李明, 葛宏松. 儿童面部获得性色素沉着斑54例临床表现、皮肤镜特征及预后分析[J]. 临床儿科杂志, 2025, 43(8): 610-614.
[11]	中国医师协会儿科医师分会肾脏疾病学组中国儿童遗尿疾病管理协作组. 中国儿童遗尿症疾病管理专家共识（2025年）[J]. 临床儿科杂志, 2025, 43(7): 483-499.
[12]	王颖硕, 陈志敏. 数智化赋能儿童支气管哮喘的诊治和管理[J]. 临床儿科杂志, 2025, 43(7): 500-504.
[13]	赵琳朝, 王英洁, 景沼贺, 买钰淼, 孙盼, 邱思敏, 牛宏运, 陈志伟, 董芃芃, 刘健. 造血干细胞移植治疗儿童遗传性骨髓衰竭综合征疗效及预后分析[J]. 临床儿科杂志, 2025, 43(7): 505-510.
[14]	张志奇, 熊若兰, 李泊涵, 吉奇, 王庆伟, 卢俊, 李捷, 肖佩芳, 胡绍燕. 儿童白血病脐带血移植原发性植入失败预测模型的构建[J]. 临床儿科杂志, 2025, 43(7): 511-518.
[15]	姜雯雯, 李思彤, 徐勇胜. 儿童肺结核γ-干扰素释放试验假阴性结果影响因素分析[J]. 临床儿科杂志, 2025, 43(7): 519-524.