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。

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.