Ⅰ型变态反应与中耳炎相关性初步研究

The Association between Type Ⅰ Allergy and Otitis Media

史聪;张海利;许婷;樊慧娟;

1:山西医科大学第一医院

摘要

目的采用卵清蛋白构建变应性鼻炎模型，探讨I型变态反应对中耳的影响。方法将18只4～6周健康雌性BALB/c小鼠随机均分对照组A组、实验组B组、实验组C组，每组6只(12耳)。实验组B、C组经卵清蛋白及佐剂Al(OH)_3腹腔注射，再分别滴鼻激发2周和4周，建立变应性鼻炎模型；对照组以PBS代替。通过行为症状学评分评估建模结果(总分≥5分建模成功),ELISA检测血清中IgE表达，HE染色后观察鼻-咽鼓管-中耳黏膜病理改变并测量三组中耳黏膜厚度，免疫组化方法检测IL-5在鼻黏膜及中耳骨髓的表达。结果行为症状学评分显示实验组B、C组变应性鼻炎模型构建成功，B组5耳发生中耳炎，C组中8耳发生中耳炎，其中3耳(25%,3/12)出现中耳积液。实验组B、C组鼻黏膜上皮细胞排列不齐，固有层增厚、腺泡分泌增加，大量嗜酸性粒细胞、中性粒细胞以及淋巴细胞浸润；中耳咽鼓管鼓室内段及近咽鼓管黏膜水肿，部分纤毛脱落，固有层增厚少量炎性细胞浸润；对照组无明显改变。测量近咽鼓管、中段中耳鼓室及鼓膜紧张部三处黏膜厚度，与对照组相比，实验组B、C组近咽鼓管处及鼓室中段黏膜明显增厚(P<0.05),但鼓膜紧张部黏膜无明显增厚(P>0.05)。免疫组织化学染色结果示实验组C组鼻黏膜及中耳骨髓腔中表达IL-5的阳性细胞数较对照组较明显增多(P<0.05)。结论 Ⅰ型变态反应作为分泌性中耳炎的危险因素，使中耳处于高反应状态，通过改变咽鼓管结构及功能影响中耳微环境，从而导致分泌性中耳炎。

关键词

中耳炎;变态反应;白细胞介素5(IL-5)

基金项目(Foundation):

作者

史聪;张海利;许婷;樊慧娟;

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中耳炎变态反应白细胞介素5(IL-5)

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史聪张海利许婷樊慧娟