阻塞性睡眠呼吸暂停低通气综合征患儿T细胞功能性极化状态及临床意义  

Functional polarization of T cells and clinical value in children with obstructive sleep apnea hypopnea syndrome

作　　者：刘鹏[1] 董亦晗[1] 徐晖[1] 王景丽[1] 李士新[1] 

机构地区：[1]大庆油田总医院耳鼻咽喉科,黑龙江省大庆163001

出　　处：《中国医师杂志》2013年第6期759-762,共4页Journal of Chinese Physician

摘　　要：目的探讨阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea hypopnea syndrome，OSAHS）患JI,J,I,周血T细胞功能性极化状态及临床意义。方法选取行扁桃体加腺样体切除术的45例OSAHS患儿为研究组，用流式细胞术检测术前和术后6个月外周血中Th1／Th2和Te1／Te2细胞比例，与正常儿童对照组（30例）比较，观察患儿Th1／Th2和Te1／Te2的变化。结果OS—AHS患儿较正常儿童Th1降低[（9．66±3．73）％VS（13．34±4．36）％，P〈0．05]、Th2升高[（3．42±1．64）％VS（2．53±1．97）％，P〈0．05]、Th1／Th2比值下降（3．51±1．53VS5．41±2．17，P〈0．05）；术后与术前比较，Th1升高[（12．99±3．68）％vs（9．66±3．73）％，P〈0．05]、Th2降低[（2．62±1．88）％VS（3．42±1．64）％，P〈0．05]、Th1／Th2比值升高（5．15±1．86v83．51±1．53，P〈0．05）；Tc1／Tc2细胞比例无明显变化（P〉0．05）。结论OSAHS患儿存在Th功能性极化异常，Th2占优势；Tc功能性极化无明显异常，患儿手术治疗能逆转Th功能性极化异常。Objective To investigate the functional polarization of T cells in children with obstructive sleep apnea hypopnea syndrome （OSAHS） . Methods Forty five cases of OSAHS children were cho- sen to undergo tonsillectomy and adenoidectomy. Preoperative analyses of peripheral blood Thl /Th2 ratio and Tcl/Tc2 ratio were compared with those of normal children and those of postoperative 6 months for ob- servation of the change of T cells. Thl /Th2 ratio and Tcl/Tc2 ratio were detected by flow cytometry. Re- sults The preoperative ratio of Thl cells in children with OSAHS was significantly lower than normal chil- dren [ （9. 66 ±3.73） % vs （13.34 ±4. 36） %, P 〈0. 05], while the preoperative ratio of Th2 cells was significantly higher than normal children [ （ 3.42 ± 1.64 ） % vs （ 2. 53 ± 1.97 ） %, P 〈 0. 05 ], which made the Thl/Th2 ratio lower than normal children （3.51 ± 1.53 vs 5.41 ±2. 17, P 〈0. 05）. At the 6th month after tonsillectomy and adenoideetomy, the postoperative ratio of Thl cells was significantly higher than preoperative ratio [ （12.99 ±3.68）% vs （9. 66 ±3.73）%, P 〈0. 05], while the postoperative ratio of Th2 cells was lower than preoperative ratio [ （ 2. 62 ± 1.88 ） % vs （ 3.42 ± 1.64 ） %, P 〈 0. 05 ], which made the postoperative Thl /Th2 ratio higher than preoperative ratio （5.15 ± l. 86 vs 3.51 ± 1.53, P 〈0. 05 ）. There was no significant difference in Tcl /Tc2 ratio between the OSAHS children and normal children. Conclusions Functional polarization of T cells was abnormal in OSAHS children accompanied by the predomination of Th2 cells and the normal Tc cell polarization. Functional polarization of T cells can return to normal at the 6th month after tonsillectomy and adenoidectomy.

关 键 词：扁桃体切除术 睡眠呼吸暂停综合征 外科学 腺样体切除术 TH1细胞 代谢 TH2 细胞 代谢 儿童 

分 类 号：R766[医药卫生—耳鼻咽喉科]