Bitar Mohamed, Mahfouz Rami, Soweid Assaad, Racoubian Eddy, Ghasham Mona, Zaatari Ghazi, Fuleihan Nabil
Department of Otolaryngology-Head and Neck Surgery, School of Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Acta Otolaryngol. 2006 Feb;126(2):154-9. doi: 10.1080/00016480500312679.
There is growing interest in studying the presence of HP in the upper aerodigestive tract. It was shown in several pilot studies that it colonizes the area, while other authors found no evidence of its presence there and a third group of authors believed that it had only a transient presence there. In this study we investigated a possible role for HP in middle ear disease in children.
Consecutive patients undergoing myringotomy and adenoidectomy for chronic otitis media with effusion or recurrent otitis media were enrolled. Middle ear fluids were cultured on three types of agar plate (Brucella + laked horse blood; Brucella + sheep blood; and chocolate). A double polymerase chain reaction (PCR) was run to detect urease-C and adhesion subunit genes. Rapid urease enzyme testing and PCR were used on the adenoid specimens. Parents were interviewed regarding symptoms suggestive of gastroesophageal reflux in their children.
Eighteen patients were enrolled in the study (mean age 4.4 years; age range 3-8 years) with an equal gender distribution. All 28 middle ear fluid cultures were negative in all 3 media. Twenty-one of the 28 samples contained DNA, yet PCR revealed that none of them belonged to HP. Ten of the 13 adenoid specimens obtained were positive on rapid urease testing, but none on PCR. Seven of the 18 patients had at least 1 symptom suggestive of gastroesophageal reflux during the 6 months preceding the study but this did not have an impact on any of the results.
There was no evidence from this study that Helicobacter pylori (HP) colonizes the nasopharynx of children with middle ear disease, whether dyspeptic or not. There is also no apparent role for this bacterium in middle ear pathology.
对上呼吸道消化道中幽门螺杆菌（HP）的存在进行研究的兴趣日益浓厚。几项初步研究表明它可在该区域定植，而其他作者未发现其存在的证据，另有一组作者认为它仅短暂存在于此。在本研究中，我们调查了HP在儿童中耳疾病中可能发挥的作用。
纳入因慢性分泌性中耳炎或复发性中耳炎而接受鼓膜切开术和腺样体切除术的连续患者。中耳积液在三种琼脂平板（布鲁氏菌 + 脱纤维马血；布鲁氏菌 + 羊血；以及巧克力平板）上进行培养。进行双重聚合酶链反应（PCR）以检测尿素酶C和黏附亚基基因。对腺样体标本进行快速尿素酶检测和PCR。就其子女提示胃食管反流的症状对家长进行访谈。
18名患者纳入研究（平均年龄4.4岁；年龄范围为3至8岁），性别分布均衡。所有28份中耳积液培养物在所有3种培养基中均为阴性。28份样本中有21份含有DNA，但PCR显示它们均不属于HP。所获取的13份腺样体标本中有10份快速尿素酶检测呈阳性，但PCR均为阴性。18名患者中有7名在研究前6个月内至少有1项提示胃食管反流的症状，但这对任何结果均无影响。
本研究没有证据表明幽门螺杆菌（HP）定植于患有中耳疾病的儿童鼻咽部，无论其是否有消化不良症状。该细菌在中耳病理过程中也没有明显作用。
