探索分泌性中耳炎与过敏性鼻炎的关联：一项系统综述

文献信息

中文摘要

引言： 分泌性中耳炎（OME）的特征是完整鼓膜后方中耳内液体积聚，常与过敏性鼻炎共存，后者是一种引起鼻塞等症状的炎症性鼻腔疾病。两种疾病在儿童中均常见，并可能共享与统一气道概念相关的免疫介导机制。既往研究提示过敏性鼻炎促进咽鼓管功能障碍和中耳积液持续，但对其相互作用的了解仍不完整。
目的： 评估过敏性鼻炎与OME之间的关联，识别危险因素、诊断方法和潜在治疗策略。
方法： 本系统综述遵循2020年系统综述和荟萃分析优先报告条目（PRISMA）声明。我们在PubMed数据库中使用医学主题词（MeSH）分泌性中耳炎和鼻炎，过敏性进行检索；共识别181篇文章，根据纳入标准缩小至15篇。
结果： 大多数研究显示过敏性鼻炎与OME之间存在显著关联，尤其在儿童中。诊断方法如皮内稀释试验显示出比皮肤点刺试验更高的敏感性。免疫治疗有效处理了两种疾病，即使在点刺试验阴性的病例中亦然。在过敏性OME中观察到微小核糖核酸320e（miR-320e）表达降低，提示其作为生物标志物的潜力。手术干预可缓解症状，但处理潜在过敏被证明至关重要。研究主要来自中国（20%）和美国（13.3%）。
结论： 过敏性鼻炎在OME发生和症状加重中起关键作用。免疫治疗可能作为预防策略，强调需要临床指南。本研究弥合了区域医学文献的空白，为临床医生提供了有价值的见解，并强调需要进一步研究以优化儿科护理结局。

英文摘要

INTRODUCTION: Otitis media with effusion (OME) is characterized by fluid accumulation in the middle ear behind an intact eardrum, often coexisting with allergic rhinitis, an inflammatory nasal condition causing symptoms such as nasal obstruction. Both conditions are prevalent in children and may share immune-mediated mechanisms linked to the unified airway concept. Previous studies suggest allergic rhinitis contributes to Eustachian-tube dysfunction and middle-ear effusion persistence, but the understanding of their interplay remains incomplete.
OBJECTIVE: To evaluate the association between allergic rhinitis and OME, identifying risk factors, diagnostic methods, and potential therapeutic strategies.
METHODS: The current systematic review adhered to the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We conducted a search on the PubMed database using the Medical Subject Headings (MeSH) otitis media with effusion and rhinitis, Allergic; we identified 181 articles, which were narrowed to 15 based on the inclusion criteria.
RESULTS: Most studies revealed a significant association between allergic rhinitis and OME, particularly in children. Diagnostic methods such as intradermal dilution testing showed higher sensitivity than skin prick tests. Immunotherapy effectively addressed both conditions, even in cases with negative prick tests. Reduced micro ribonucleic acid (microRNA) 320e (miR-320e) expression was noted in allergic OME, suggesting potential as a biomarker. Surgical intervention provided symptom relief, but addressing underlying allergies proved essential. The studies were predominantly from China (20%) and the United States (13.3%).
CONCLUSION: Allergic rhinitis plays a crucial role in OME development and symptom exacerbation. Immunotherapy may serve as a preventive strategy, emphasizing the need for clinical guidelines. The present study bridges gaps in regional medical literature, offering valuable insights for clinicians and highlighting the need for further research to optimize pediatric care outcomes.