腺样体、扁桃体切除术对OSAHS患儿免疫功能的影响

金书香; 王吉喆; 曲慧

doi:10.13201/j.issn.1001-1781.2017.23.008

腺样体、扁桃体切除术对OSAHS患儿免疫功能的影响

- 大连医科大学附属第二医院耳鼻咽喉科(辽宁大连, 116027)

详细信息

通讯作者: 曲慧, E-mail:cat19860507@sina.com

中图分类号: R563.8;R767.91

收稿日期: 2017-09-14

Effects of adenotonsillectomy on immunoregulation in children with obstructive sleep apnea hypopnea syndrome

- Department of Otorhinolaryngology, the Second Affiliated Hospital of Dalian Medical University, Dalian, 116027, China

More Information

Corresponding author: QU Hui, E-mail: cat19860507@sina.com

Received Date: 14 September 2017

摘要

摘要: 目的: 比较健康儿童和OSAHS患儿术前、术后淋巴细胞亚群、NK细胞和免疫球蛋白,探讨OSAHS患儿与健康儿童免疫功能的差异及腺样体、扁桃体切除术对OSAHS患儿免疫功能的影响。方法: 收集OSAHS患儿36例作为OSAHS组,健康儿童40例为对照组,采集对照组和OSAHS组术前1 d的血液标本。OSAHS组患儿在全身麻醉下行腺样体、扁桃体切除术。采集OSAHS组儿童术后4 d及1、3、6个月血液标本。所有患者均行淋巴细胞亚群、NK细胞和免疫球蛋白检测。结果: ①OSAHS组术前1 d的IgA低于对照组(P<0.01)。②OSAHS组术前1 d的CD4⁺T细胞百分比、CD4⁺/CD8⁺比值均低于对照组(P<0.01或<0.05)。OSAHS组术前1 d的CD8⁺T细胞百分比高于对照组(P<0.01)。③OSAHS组术后4 d、1个月的IgG较术前均降低(P<0.05);术后3、6个月时IgA较术前均明显升高(P<0.01或<0.05)。④OSAHS组术后4 d CD4⁺T、CD3⁺T及NK细胞百分比、CD4⁺/CD8⁺比值均低于术前,CD8⁺T细胞百分比则高于术前,差异均有统计学意义(P<0.05)。术后3、6个月的CD4⁺T百分比、CD4⁺/CD8⁺比值均高于术前,CD8⁺T低于术前,差异均有统计学意义(P<0.01或<0.05)。结论: ①OSAHS患儿与健康儿童相比,存在一定程度的细胞及体液免疫紊乱,同时伴有不同程度的细胞及体液免疫功能下降。②OSAHS患儿细胞及体液免疫功能在术后1个月内均降低,但至术后6个月可恢复至健康儿童的水平,腺样体、扁桃体切除术有助于恢复OSAHS患儿的免疫功能。
- 睡眠呼吸暂停低通气综合征 /
- 阻塞性 /
- 腺样体切除术 /
- 扁桃体 /
- 淋巴细胞亚群 /
- NK细胞 /
- 免疫球蛋白
Abstract: Objective: To observe the effects of adenotonsillectomy on immunoregulation in children with obstructive sleep apnea hypopnea syndrome.Method: Thirty-six OSAHS children were recruited as an experimental group while 40 healthy children for the control group. Blood samples were collected from experimental group and control group. Tonsillectomy and adenoidectomy were performed under general anesthesia in the experimental group. Blood samples of the experimental group were collected at 4 days, 1, 3 and 6 months after operation, respectively. Lymphocyte subsets, NK cells and immunoglobulin were analysis in all patients.Result: ①The expression of IgA in the experimental group was significantly lower than the control group before operation (P<0.01). No significant difference was found between the other groups (P>0.05). ②The percentage of CD4⁺T cells and CD4⁺/CD8⁺ ratio in the experimental group were significantly lower than those in the control group before operation (P<0.01 or <0.05). The percentage of CD8⁺ T cells in experimental group was significantly higher than that in control group one day before operation (P<0.01). ③In the experimental group, the expression of IgG at 4 days and 1 month was significantly lower than that before operation (P<0.05). At 3 and 6 months after operation, IgA was significantly higher than that before operation, the difference was statistically significant (P<0.01 or <0.05). No significant difference was found between the other groups (P>0.05). ④The percentage of CD4⁺T, CD3⁺T and NK cells, CD4⁺/CD8⁺ ratio in the experimental group at post-operative 4 days were lower than those before operation, and the percentage of CD8⁺T cells was CD4⁺/CD8⁺ ratio in 3 and 6 months after operation was higher than that before operation, and CD8⁺T was lower than before operation,the difference was statistically significant (P<0.01 or <0.05). No significant difference was found between the other groups (P>0.05).Conclusion: ①Compared with healthy children, OSAHS children have a certain degree of cellular and humoral immune disorders, accompanied by different levels of cellular and humoral immune function decline. ②The cellular and humoral immune function in children with obstructive sleep apnea hypopnea syndrome (OSAHS) decreased within 1 month, but recovered to healthy children at 6 months after operation. Adenoidectomy and tonsillectomy were helpful to restore the immune function of children with OSAHS.
- sleep apnea hypopnea syndrome /
- obstructive /
- adenoidectomy /
- tonsil /
- lymphocyte subsets /
- NK cell /
- immunoglobulin

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