Henderson F W, Collier A M, Sanyal M A, Watkins J M, Fairclough D L, Clyde W A, Denny F W
N Engl J Med. 1982 Jun 10;306(23):1377-83. doi: 10.1056/NEJM198206103062301.
We analyzed data from a 14-year longitudinal study of respiratory infections in young children to determine the relative importance of viral respiratory infection and nasopharyngeal colonization with Streptococcus pneumoniae and Haemophilus influenzae as factors influencing the occurrence of acute otitis media with effusion. The incidence of this disorder was increased in children with viral respiratory infections (average relative risk, 3.2; P less than 0.0001). Infection with respiratory syncytial virus, influenza virus (type A or B), and adenovirus conferred a greater risk of otitis media than did infection with parainfluenza virus, enterovirus, or rhinovirus. Colonization of the nasopharynx with Str. pneumoniae or H. influenzae had a lesser effect on the incidence of the disease (average relative risk; 1.5; P less than 0.01). Infections with the viruses more closely associated with acute otitis media (respiratory syncytial virus, adenovirus, and influenza A or B) were correlated with an increased risk of recurrent disease. Prevention of selected otitis-associated viral infections should reduce the incidence of this disease.
我们分析了一项针对幼儿呼吸道感染的14年纵向研究的数据，以确定病毒性呼吸道感染以及肺炎链球菌和流感嗜血杆菌在鼻咽部的定植作为影响急性渗出性中耳炎发生的因素的相对重要性。病毒性呼吸道感染患儿中这种疾病的发病率有所增加（平均相对风险为3.2；P<0.0001）。与副流感病毒、肠道病毒或鼻病毒感染相比，呼吸道合胞病毒、流感病毒（甲型或乙型）和腺病毒感染导致中耳炎的风险更高。肺炎链球菌或流感嗜血杆菌在鼻咽部的定植对该病发病率的影响较小（平均相对风险为1.5；P<0.01）。与急性中耳炎关系更密切的病毒（呼吸道合胞病毒、腺病毒和甲型或乙型流感病毒）感染与疾病复发风险增加相关。预防特定的与中耳炎相关的病毒感染应能降低该病的发病率。
