| Objective: Acute secretory otitis media is a common otologic disease in clinical,which is harm to life and health of patients seriously,If it could be not diagnosed and treated timely,it will arise the decline in the quality of patients’ life and serious economic burden,therefore,it is important to diagnose the early stage of acute secretory otitis media rapidly.At present,the etiology and pathogenic mechanism of acute secretory otitis media is complex,the timely diagnosis and treatment is still controversial.Meanwhile,the study on immunity correlation biochemical indexes for diagnosis and classification of the acute secretory otitis media has been made great progress,But there are also many contradictions and disputes on these issues.This paper will study the immunity correlation biochemical indexes including T cell subsets and cytokines IL-2,IL-4 and IL-6,to explore the expression of CD4~+,CD8~+T cells and IL-2,IL-4,IL-6s with acute secretory otitis media,and to provide the guidances for the early clinical diagnosis of acute secretory otitis media.Methods: From November of 2015 to February of 2017,in the Department of ENT,the Second Affiliated Hospital of North Sichuan Medical College,We chose cases which had be diagnosed as acute secretory otitis media in outpatient and inpatient into the observation group,the control group were normal healthy people.The analysis of CD4~+,CD8~+ and CD4~+/CD8~+ ratio of the observation group and the control group in peripheral blood were analysed by flow cytometry,and the analysis of IL-2,IL-4,IL-6 cytokine levels in peripheral blood and ear effusion in the observation group were gauged by ELISA commercial kit.Meanwhile,in theobservation group,we analyze the correlation of cytokines with CD4~+/CD8~+ratio by Pearson test.Results: In this study,a total of 95 cases were selected,including observation group(n=47)and control group(n=48).There was no significant difference in gender,age,BMI,drinking history,smoking history and other basic data of the two groups of subjects which analyzed by the t/χ2 test.There was statistically significant difference of the percentage of CD4~+and CD8~+ in the peripheral blood of the observation group and the control group,both of the percentage of CD4~+and CD8~+ in the observation group were significantly increased(t=15.91,P<0.001;t=21.53,P<0.001);The CD4~+/CD8~+ ratio in the observation group and the control group was statistically significant difference(t=2.78,P<0.001).The CD4~+/CD8~+ ratio of observation group was significantly lower than the control group.IL-2 level in two groups of subjects in peripheral blood with a statistically significant difference(t=3.22,P<0.001),IL-2 level in the observation group decreased;the IL-4 and IL-6 in observation group and control group in peripheral blood of patients was no significant difference(t=1.54,P=0.36;t=0.81,P=0.015).The levels of IL-2and IL-6 in the ear effusion of the observation group were significantly higher than those of the control group and the observation group(t=11.31,P<0.001;t=13.30,P<0.001).The level of IL-4 in the ear effusion of the observation group compared with that of the observation group,there was no significant difference(t=0.42,P=0.503).By Pearson test,CD4~+/CD8~+ ratio in peripheral blood of patients in observation group were positively correlated with IL-2and IL-6 in ear effusion(r=0.598,P<0.001;r=0.526,P<0.001).Conclusions: Through studying T cell subsets and IL-2,IL-4,IL-6cytokines on the observation group(acute secretory otitis media patients)and control group(healthy)in the peripheral blood and IL-2 IL-4 and IL-6cytokine levels in ear effusion,we can draw the following conclusions:(1)in peripheral blood,the CD4~+,CD8~+ T cell subsets and in the observation group were significantly higher than those in the control group,meanwhile the CD4~+/CD8~+ ratio in peripheral blood of patients in observation group was significantly lower than that in the control group;(2)cytokine IL-4 in the peripheral blood of the observation group and the control group,as well as the observation group,there was no significant changes in the ear,IL-4 was lack of clinical significance for the early diagnosis of acute secretory otitis media;(3)no significant difference was found of cytokine IL-6 in the peripheral blood of the observation group and the control group,IL-2 in the observation group decreased slightly,IL-2 and IL-6 was in ear effusion of the observation group,were significantly increased,IL-2 and IL-6 has certain clinical significance for the early diagnosis of acute secretory otitis media;(4)the IL-2 and IL-6 in ear effusion and CD4~+/CD8~+ ratio in peripheral blood was positively correlated in the observation group,indicated that the immune response of CD4~+ and CD8~+ T cells caused by inflammation and infection invasion synchronized with IL-2 and IL-6 in patients with acute secretory otitis media,and existed the parallel upward trend. |
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