腺样体、扁桃体切除术对OSAHS患儿免疫功能的影响

发布时间：2018-05-24 23:33

本文选题：睡眠呼吸暂停低通气综合征 + 阻塞性　；参考：《临床耳鼻咽喉头颈外科杂志》2017年23期

【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1d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4d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:(1)OSAHS组术前1d的IgA低于对照组(P0.01)。(2)OSAHS组术前1d的CD4~+T细胞百分比、CD4~+/CD8~+比值均低于对照组(P0.01或0.05)。OSAHS组术前1d的CD8~+T细胞百分比高于对照组(P0.01)。(3)OSAHS组术后4d、1个月的IgG较术前均降低(P0.05);术后3、6个月时IgA较术前均明显升高(P0.01或0.05)。(4)OSAHS组术后4dCD4~+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(P0.05)。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(P0.01或0.05)。结论:(1)OSAHS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。(2)OSAHS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。
[Abstract]:Objective: to compare the lymphocyte subsets NK cells and immunoglobulin between healthy children and children with OSAHS before and after operation, and to investigate the difference of immune function between OSAHS and healthy children and the effect of adenoidectomy and tonsillectomy on the immune function of OSAHS children. Methods: 36 children with OSAHS were selected as OSAHS group and 40 healthy children as control group. The blood samples of control group and OSAHS group were collected one day before operation. The patients in OSAHS group were subjected to adenoid and tonsillectomy under general anesthesia. Blood samples of children in OSAHS group were collected 4 days, 1 day, 3 months and 6 months after operation. All patients were examined for lymphocyte subsets NK cells and immunoglobulin. Results the percentage of CD4 ~ T cells in the control group was lower than that in the control group on the 1st day before operation. The percentage of CD4 ~ / CD8T cells in the control group was lower than that in the control group (P0.01) or in the 0.05).OSAHS group on the 1st day before operation. The percentage of CD8T cells in the control group was higher than that in the control group (P0.01.3OSAHS group) 4 days after operation. The IgG of one month was higher than that of the preoperative group. In the P0.01 or 0.05).(4)OSAHS groups, the percentage of CD4 ~ TnCD3T and NK cells were significantly lower than that of the preoperative CD8T cells, and the percentage of CD4- / -CD8T cells was higher than that of the patients with P0.01 or 0.05).(4)OSAHS patients at the 3rd and 6th month after operation, and the percentage of CD4 ~ / CD8T cells was higher in the 0.05).(4)OSAHS group than in the pre-operation group. The difference was statistically significant (P 0.05). The percentage of CD4T / CD8T at 3 and 6 months after operation was significantly higher than that of preoperative CD8T, and the difference was statistically significant (P0.01 or 0.05). Conclusion compared with healthy children, the children with OSAHS have some cellular and humoral immune disorders, and the cellular and humoral immune function of OSAHS patients with different degrees of cellular and humoral immunity decreased within one month after operation. However, by 6 months after operation, the level of healthy children could be restored. Adenoidectomy and tonsillectomy were helpful to restore the immune function of children with OSAHS.
【作者单位】：大连医科大学附属第二医院耳鼻咽喉科;
【分类号】：R766

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