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苏州市中小学生腺样体肥大及并发分泌性中耳炎分析

方琴 陶朵朵

方琴, 陶朵朵. 苏州市中小学生腺样体肥大及并发分泌性中耳炎分析[J]. 中国学校卫生, 2021, 42(11): 1728-1731, 1735. doi: 10.16835/j.cnki.1000-9817.2021.11.029
引用本文: 方琴, 陶朵朵. 苏州市中小学生腺样体肥大及并发分泌性中耳炎分析[J]. 中国学校卫生, 2021, 42(11): 1728-1731, 1735. doi: 10.16835/j.cnki.1000-9817.2021.11.029
FANG Qin, TAO Duoduo. Analysis of adenoid hypertrophy and secretory otitis media in primary and middle school students in Suzhou[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2021, 42(11): 1728-1731, 1735. doi: 10.16835/j.cnki.1000-9817.2021.11.029
Citation: FANG Qin, TAO Duoduo. Analysis of adenoid hypertrophy and secretory otitis media in primary and middle school students in Suzhou[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2021, 42(11): 1728-1731, 1735. doi: 10.16835/j.cnki.1000-9817.2021.11.029

苏州市中小学生腺样体肥大及并发分泌性中耳炎分析

doi: 10.16835/j.cnki.1000-9817.2021.11.029
基金项目: 

国家自然科学基金项目 81600796

江苏省科技项目 BK20160344

详细信息
    作者简介:

    方琴(1988-), 女, 江苏苏州人,大学本科, 主管护师,主要研究方向为耳鼻咽喉疾病及护理

  • 中图分类号: R181.3  R179  R764.21

Analysis of adenoid hypertrophy and secretory otitis media in primary and middle school students in Suzhou

  • 摘要:   目的  分析苏州市7~16岁中小学生腺样体肥大发病情况及并发分泌性中耳炎危险因素,为临床诊断治疗及预后评估提供参考。  方法  整群分层抽取苏州市2015年1月—2019年12月2 986名7~16岁中小学生为研究对象,采用整群分层抽样调查腺样体肥大疑似病例、磁共振检查确诊的方法,分析7~16岁中小学生腺样体肥大流行病学及并发分泌性中耳炎相关危险因素。  结果  中小学生发生腺样体肥大327例,检出率10.95%。2015—2019年中小学生腺样体肥大检出率呈逐年上升趋势,2019年检出率10.95%高于2015年9.20%、2016年9.95%。男生腺样体肥大检出率(12.29%)高于女生(9.48%)(χ2=6.04, P < 0.05)。7~10岁腺样体肥大检出率(15.08%)高于11~16岁中小学生(6.36%)(χ2=57.93, P < 0.05)。327例腺样体肥大中小学生中,合并分泌性中耳炎20例,合并率为6.12%。合并分泌性中耳炎组年龄低于未合并组,腺样体肥大严重程度高于未合并组,血清IL-4、TNF-α、IgA、IgG、IgM高于未合并组(P值均 < 0.05)。腺样体肥大并发分泌性中耳炎与年龄、严重程度、IL-4、IgG、IgM相关(P值均 < 0.05)。  结论  苏州市7~16岁中小学生腺样体肥大发病率较高,与性别、年龄、发病时间及季节有关,且易并发分泌性中耳炎,应引起全社会足够的重视。
  • 表  1  苏州市不同特征中小学生腺样体肥大检出率比较

    Table  1.   Comparison of the detection rate of adenoid hypertrophy among primary and middle school students with different characteristics in Suzhou City

    人口统计学指标 选项 人数 腺样体肥大人数 χ2 P
    性别 1 562 192(12.29) 6.04 0.01
    1 424 135(9.48)
    年龄/岁 7 390 64(16.41) 66.90 <0.01
    8 394 60(15.23)
    9 382 57(14.92)
    10 406 56(13.79)
    11 342 28(8.19)
    12 332 26(7.83)
    13 176 14(7.95)
    14 168 10(5.95)
    15 181 8(4.42)
    16 215 4(1.86)
    年份/年 2015 587 49(8.35) 12.98 0.01
    2016 583 56(9.61)
    2017 594 59(9.93)
    2018 605 77(12.73)
    2019 617 86(13.94)
    :()内数字为检出率/%。
    下载: 导出CSV

    表  2  不同组别中小学生腺样体肥大合并分泌性中耳炎检出率比较

    Table  2.   Comparison of the detection rate of adenoid hypertrophy with secretory otitis media among different groups of primary and middle school students

    组别 选项 人数 检出人数 χ2 P
    性别 192 14(7.29) 1.12 0.29
    135 6(4.44)
    严重程度 轻度 89 1(1.12) 5.66 0.06
    中度 114 8(7.02)
    重度 124 11(8.87)
    肥胖程度 正常 131 6(4.58) 1.74 0.42
    超重 119 7(5.88)
    肥胖 77 7(9.09)
    :()内数字为检出率/%。
    下载: 导出CSV

    表  3  中小学生腺样体肥大并发分泌性中耳炎多因素Logistic回归分析(n=2 986)

    Table  3.   Multivariate Logistics regression analysis of adenoid hypertrophy complicated by secretory otitis media(n=2 986)

    自变量 β Wald χ2 P OR值(OR值95%CI)
    年龄 0.53 12.78 <0.01 0.21(0.09~0.50)
    严重程度
      中度 0.07 1.34 0.25 22.26(0.12~4 273.25)
      重度 0.06 0.58 0.45 7.56(0.04~1 364.93)
    IL-4 0.31 5.54 0.02 1.07(1.01~1.16)
    TNF 0.13 2.92 0.09 1.05(0.99~1.12)
    IGA 0.09 1.90 0.17 1.00(1.00~1.01)
    IGG 0.35 6.12 0.01 3.20(1.27~8.04)
    IGM 0.24 4.00 0.05 1.00(1.00~1.01)
    下载: 导出CSV
  • [1] 杨环, 杨再波, 朱彬, 等. 下颌后缩伴腺样体肥大患儿生长发育水平的临床研究[J]. 临床口腔医学杂志, 2020, 36(6): 356-359. doi: 10.3969/j.issn.1003-1634.2020.06.011

    YANG H, YANG Z B, ZHU B, et al. Clinical study on the growth and development of children with mandibular retraction and adenoid hypertrophy[J]. J Clin Stomatol, 2020, 36(6): 356-359. doi: 10.3969/j.issn.1003-1634.2020.06.011
    [2] PEREIRA L, MONYROR J, ALMEIDA F T, et al. Prevalence of adenoid hypertrophy: a systematic review and Meta-analysis [J]. Sleep Med Rev, 2018, 38: 101-112. doi: 10.1016/j.smrv.2017.06.001
    [3] 邓慧仪, 杨钦泰, 王玮豪, 等. 儿童腺样体肥大合并变应性鼻炎对分泌性中耳炎发生率的影响[J]. 中山大学学报(医学科学版), 2017, 38(1): 101-105. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSYK201701016.htm

    DENG H Y, YANG Q T, WANG W H, et al. Incidence of otitis media with effusion in adenoid hypertrophy with allergic rhinitis in children[J]. J Sun Yat-sen Univ(Med Sci), 2017, 38(1): 101-105. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSYK201701016.htm
    [4] 孙书臣, 马彦, 乔静, 等. 《儿童腺样体肥大引发睡眠呼吸障碍的中医诊疗专家共识》解读[J]. 世界睡眠医学杂志, 2014, 1(6): 316-320. https://www.cnki.com.cn/Article/CJFDTOTAL-SMZZ201406003.htm

    SUN S C, MA Y, QIAO J, et al. Expert consensus on diagnosis and treatment of sleep disordered breathing in children caused by adenoid hypertrophy[J]. World J Sleep Med, 2014, 1(6): 316-320. https://www.cnki.com.cn/Article/CJFDTOTAL-SMZZ201406003.htm
    [5] 龙冬秋, 吴细黄. 中山地区学龄儿童腺样体肥厚流行病学调查[J]. 现代诊断与治疗, 2016, 27(13): 2501-2503. https://www.cnki.com.cn/Article/CJFDTOTAL-XDZD201613084.htm

    LONG D Q, WU X H. Epidemiological survey of adenoid hypertrophy in school-age children in Zhongshan area[J]. Modern Diagnosis and Treat, 2016, 27(13): 2501-2503. https://www.cnki.com.cn/Article/CJFDTOTAL-XDZD201613084.htm
    [6] MITCHELL R B, KELY J. Long-term changes in behavior after adenotosillectomy for obstructive sleep apnea syndrome in children [J]. Otolaryngol Head Neck Surg, 2006, 134(3): 374-378. doi: 10.1016/j.otohns.2005.11.035
    [7] 邹明舜. 儿童增殖腺-鼻咽腔比率测定的临床价值[J]. 中华放射学杂志, 1997, 31(4): 190-192. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHGS703.014.htm

    ZOU M S. The adenoid-nasopharynx ratio: its clinical value in children[J]. Chin J Radicl, 1997, 31(4): 190-192. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHGS703.014.htm
    [8] 中华耳鼻咽喉头颈外科杂志编辑委员会. 儿童中耳炎诊断和治疗指南(草案)[J]. 中华耳鼻咽喉头颈外科杂志, 2008, 43(12): 884-885. doi: 10.3321/j.issn:1673-0860.2008.12.002

    Editorial Committee of Chinese Journal of Otorhinolaryngology Head and Neck Surgery. Draft of guideline for the diagnosis and treatment of pediatric otitis media[J]. Chin J Otorhinolaryngol Head Neck Surgery, 2008, 43(12): 884-885. doi: 10.3321/j.issn:1673-0860.2008.12.002
    [9] 国家卫生和计划生育委员会. 学龄儿童青少年超重与肥胖筛查: WS/T 586—2018[S]. 2018-02-23.

    National Health and Family Planning Commission of the People's Republic of China. Screening for overweight and obesity among school-age children and adolescents: WS/T 586-2018[S]. 2018-02-23.
    [10] SAKARYA E U, BAYAR MULUK N, SAKALAR E G, et al. Use of intranasal corticosteroids in adenotonsillar hypertrophy [J]. J Laryngol Otol, 2017, 131(5): 384-390. doi: 10.1017/S0022215117000408
    [11] BHAT V, MANI I, AROOR R, et al. Association of asymptomatic otitis media with effusion in patients with adenoid hypertrophy [J]. J Otol, 2019, 14(3): 106-110. doi: 10.1016/j.joto.2018.12.001
    [12] 崔莉, 王娟, 苏金柱. 腺样体肥大儿童淋巴细胞亚群表达的临床分析[J]. 河北医药, 2016, 38(20): 3128-3130. https://www.cnki.com.cn/Article/CJFDTOTAL-HBYZ201620023.htm

    CUI L, WANG J, SU J Z. Clinical analysis of the expression of lymphocyte subsets in children with adenoid hypertrophy[J]. Hebei Med J, 2016, 38(20): 3128-3130. https://www.cnki.com.cn/Article/CJFDTOTAL-HBYZ201620023.htm
    [13] 刘瑞, 孙书臣. 腺样体肥大儿童的一般情况分析[J]. 世界睡眠医学杂志, 2019, 6(1): 65-67. doi: 10.3969/j.issn.2095-7130.2019.01.026

    LIU R, SUN S C. Analysis of general situation of children with adenoid hypertrophy[J]. World J Sleep Med, 2019, 6(1): 65-67. doi: 10.3969/j.issn.2095-7130.2019.01.026
    [14] 赫莉, 宋英鸾, 耿江桥, 等. 变应原筛查在儿童腺样体肥大中的研究[J]. 中国耳鼻咽喉头颈外科, 2020, 27(9): 543-545. https://www.cnki.com.cn/Article/CJFDTOTAL-EBYT202009014.htm

    HE L, SONG Y L, GENG J Q, et al. Research on allergen screening in children with adenoid hypertrophy[J]. Chin Otorhinolaryngol Head Neck Surgery, 2020, 27(9): 543-545. https://www.cnki.com.cn/Article/CJFDTOTAL-EBYT202009014.htm
    [15] SHIN J H, KIM B G, KIM B Y, et al. Is there an association between Vitamin D deficiency and adenotonsillar hypertrophy in children with sleep-disordered breathing? [J]. BMC Pediatr, 2018, 18(1): 196. doi: 10.1186/s12887-018-1178-8
    [16] 张迎俊, 袁菲, 刘颖慧, 等. 腺样体肥大儿童的变应原检测及病因探讨[J]. 临床耳鼻咽喉头颈外科杂志, 2017, 31(7): 549-551. https://www.cnki.com.cn/Article/CJFDTOTAL-LCEH201707014.htm

    ZHANG Y J, YUAN F, LIU Y H, et al. Allergen detection and etiology study of adenoidal hypertrophy in children[J]. J Clin Otorhinolaryngol Head Neck Surgery, 2017, 31(7): 549-551. https://www.cnki.com.cn/Article/CJFDTOTAL-LCEH201707014.htm
    [17] 易星, 谢邵兵, 吴学文, 等. 儿童腺样体肥大并发分泌性中耳炎的危险因素分析[J]. 听力学及言语疾病杂志, 2017, 25(6): 658-660. doi: 10.3969/j.issn.1006-7299.2017.06.026

    YI X, XIE S B, WU X W, et al. Analysis of risk factors for adenoid hypertrophy in children with secretory otitis media[J]. J Audiol Speech Dis, 2017, 25(6): 658-660. doi: 10.3969/j.issn.1006-7299.2017.06.026
    [18] 赫莉, 耿江桥, 左路杰, 等. 学龄前儿童腺样体肥大合并分泌性中耳炎的相关因素分析[J]. 中华耳科学杂志, 2020, 18(5): 852-856. doi: 10.3969/j.issn.1672-2922.2020.05.008

    HE L, GENG J Q, ZUO L J, et al. Correlative factors of adenoidal hypertrophy complicated with otitis media with effusion in preschool children[J]. Chin J Otol, 2020, 18(5): 852-856. doi: 10.3969/j.issn.1672-2922.2020.05.008
    [19] SAHIN O A, KECECIOGLU N, SERDAR M, et al. The association of residential mold exposure and adenotonsillar hypertrophy in children living in damp environments [J]. Int J Pediatr Otorhinolaryngol, 2016, 88: 233-238. doi: 10.1016/j.ijporl.2016.07.018
    [20] 柴伟, 徐甜甜, 黄辉, 等. 腺样体肥大伴发分泌性中耳炎与腺样体鼻咽比率相关性研究[J]. 中华耳科学杂志, 2019, 17(6): 926-928. doi: 10.3969/j.issn.1672-2922.2019.06.024

    CHAI W, XU T T, HUANG H, et al. A retrospective analysis of A/N ratio in children with adenoid hypertrophy associated with secretory otitis media[J]. Chin J Otol, 2019, 17(6): 926-928. doi: 10.3969/j.issn.1672-2922.2019.06.024
    [21] KAR M, ALTINTOPRAK N, MULUK N B, et al. Antleukotrienes in adenotonsillar hypertophy: a review of the literature [J]. Eur Arch Otorhinolaryngol, 2016, 273(12): 4111-4117. doi: 10.1007/s00405-016-3983-8
    [22] 张丽净, 宋西成, 贾传亮, 等. 血清中炎症介质和细胞因子与儿童腺样体肥大相关性研究[J]. 山东大学耳鼻咽喉眼学报, 2014, 28(2): 58-61. https://www.cnki.com.cn/Article/CJFDTOTAL-SDYU201402017.htm

    ZHANG L J, SONG X C, JIA C L, et al. Relationship between children with adenoid vegetation and inflammatory mediators and cyokines[J]. J Otolaryngol Ophthalmol Shandong Univ, 2014, 28(2): 58-61. https://www.cnki.com.cn/Article/CJFDTOTAL-SDYU201402017.htm
    [23] GAO K, LI Y Z, YUE Z Y, et al. Down-regulation of anti-inflammatory TIPE2 may aggravate adenoidal hypertrophy in children [J]. FEBS Open Biol, 2020, 10(5): 761-766. doi: 10.1002/2211-5463.12821
    [24] 董家琪, 姜妍, 黄世勇, 等. 分泌性中耳炎儿童腺样体组织中IL-10、INF-γ表达[J]. 听力学及言语疾病杂志, 2020, 28(2): 149-152. https://www.cnki.com.cn/Article/CJFDTOTAL-TLXJ202002009.htm

    DONG J Q, JIANG Y, HUANG S Y, et al. Expression of INF-γ and IL-10 in adenoid tissues of children with secretory otitis media[J]. J Audiol Speech Pathol, 2020, 28(2): 149-152. https://www.cnki.com.cn/Article/CJFDTOTAL-TLXJ202002009.htm
    [25] MARCANO A E, CARRASCO L M, TORTAJADA G M, et al. Impact of adenotonsillectomy on the evolution of inflammatory markers [J]. Clin Otolaryngol, 2019, 44(6): 983-988. doi: 10.1111/coa.13423
    [26] 于海玲, 张莉, 宋惠芸, 等. 腺样体肥大儿童并发分泌性中耳炎调查及影响因素分析[J]. 中国妇幼保健, 2017, 32(15): 3518-3520. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201715042.htm

    YU H L, ZHANG L, SONG H Y, et al. Investigation and influencing factors analysis of secretory otitis media in children with adenoid hypertrophy[J]. Matern Child Health Care Chin, 2017, 32(15): 3518-3520. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201715042.htm
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出版历程
  • 收稿日期:  2021-06-23
  • 修回日期:  2021-08-31
  • 网络出版日期:  2021-12-01
  • 刊出日期:  2021-11-25

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