Yilmaz Taner, Koçan Elif Gülin, Besler H Tanju, Yilmaz Gonca, Gürsel Bülent
Department of Otolaryngology--Head and Neck Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Otolaryngol Head Neck Surg. 2004 Dec;131(6):797-803. doi: 10.1016/j.otohns.2004.07.001.
Determine the possible role of oxidants and antioxidants in the pathogenesis of otitis media with effusion in children.
Randomized controlled trial, tertiary referral center. The study group was made up of children with otitis media with effusion who were to undergo bilateral ventilation tube insertion and adenoidectomy. The control group was comprised of otherwise healthy children. The blood levels of antioxidants (retinol, beta-carotene, alpha-tocopherol, laycopene, ascorbic acid, superoxide dismutase, glutathione peroxidase, GSH) and oxidation products (malondialdehyde) were determined before and 1 month after the operation in the study group and once only in the control group. These substances were also measured in the adenoid tissue and middle ear fluids.
In the study group, the blood levels of antioxidants and oxidants before and after the operation were significantly different when compared with the control group (P < 0.05). In the study group, the blood antioxidant levels increased and oxidant levels decreased significantly after the operation (P < 0.05). The levels after the operation never reached those of the control group.
Oxidants and antioxidants played a significant role in the pathogenesis of otitis media with effusion in children. These children are under significant oxidative stress. Insertion of a ventilation tube and adenoidectomy significantly decreased the oxidative stress in these patients, but could not normalize it completely. Additional studies are necessary in the clinical use of antioxidants in otitis media with effusion.
确定氧化剂和抗氧化剂在儿童分泌性中耳炎发病机制中可能发挥的作用。
随机对照试验，三级转诊中心。研究组由即将接受双侧鼓膜置管和腺样体切除术的分泌性中耳炎患儿组成。对照组由健康儿童组成。在研究组手术前和术后1个月测定抗氧化剂（视黄醇、β-胡萝卜素、α-生育酚、番茄红素、抗坏血酸、超氧化物歧化酶、谷胱甘肽过氧化物酶、谷胱甘肽）和氧化产物（丙二醛）的血液水平，对照组仅测定一次。还对腺样体组织和中耳液中的这些物质进行了测量。
研究组手术前后血液中抗氧化剂和氧化剂水平与对照组相比有显著差异（P < 0.05）。研究组术后血液抗氧化剂水平显著升高，氧化剂水平显著降低（P < 0.05）。术后水平从未达到对照组水平。
氧化剂和抗氧化剂在儿童分泌性中耳炎发病机制中起重要作用。这些儿童处于显著的氧化应激状态。鼓膜置管和腺样体切除术显著降低了这些患者的氧化应激，但未能使其完全恢复正常。在分泌性中耳炎中抗氧化剂的临床应用方面还需要进一步研究。
