Lim D J, DeMaria T F, Bakaletz L O
Department of Otolaryngology, Ohio State University College of Medicine, Columbus.
Acta Otolaryngol Suppl. 1988;458:174-80. doi: 10.3109/00016488809125125.
A number of important factors singly or in combination contribute to the pathogenesis of otitis media. These are poor tubal function, upper respiratory viral infection, bacterial adherence and nasopharyngeal flora, and immune status of the host. One of the important functions of the tubotympanum is to protect the middle ear from invading microbes. The host has available a number of strategies for this function including mucociliary protection, antibacterial secretory products, and specific immunodefenses. The microbes also possess the capability of escaping host defenses by enhancing their ability to adhere to mucosal surfaces, impairing mucociliary function and evading phagocytosis. Once microbes gain entrance to the middle ear, the microbes must overcome phagocytosis and immunodefense of the host, leading to otitis media. Recent data further indicate that specific qualitative and quantitative deficiencies in the immune system of children may predispose certain children to develop otitis media. These deficiencies appear to be in part due to a lack of maturity of the child's developing immune system as well as functional defects that are attributable to genetic or other unknown factors.
多种重要因素单独或共同作用导致中耳炎的发病机制。这些因素包括咽鼓管功能不良、上呼吸道病毒感染、细菌黏附和鼻咽部菌群以及宿主的免疫状态。鼓室咽鼓管的一项重要功能是保护中耳免受微生物入侵。宿主为此功能具备多种策略，包括黏液纤毛保护、抗菌分泌产物和特异性免疫防御。微生物也有能力通过增强其黏附黏膜表面的能力、损害黏液纤毛功能和逃避吞噬作用来逃避宿主防御。一旦微生物进入中耳，它们必须克服宿主的吞噬作用和免疫防御，从而导致中耳炎。最新数据进一步表明，儿童免疫系统中特定的质量和数量缺陷可能使某些儿童易患中耳炎。这些缺陷似乎部分归因于儿童发育中的免疫系统缺乏成熟度以及可归因于遗传或其他未知因素的功能缺陷。
