扁桃体加腺样体切除术对OSAHS患儿免疫功能的影响  

Influence of tonsillectomy and adenoidectomy on immune function in children with obstructive sleep apnea hypopnea syndrome

作　　者：刘石[1] 刘鹏[1] 徐晖[1] 李士新[1] 

机构地区：[1]黑龙江省大庆油田总医院耳鼻咽喉科,163001

出　　处：《齐齐哈尔医学院学报》2014年第4期504-506,共3页Journal of Qiqihar Medical University

摘　　要：目的探讨扁桃体加腺样体切除术对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患儿免疫功能的影响。方法选取45例OSAHS患儿行扁桃体加腺样体切除术,检测术前、术后1、6个月血清中C3、C4、IgA、IgG、IgM的含量和唾液中分泌型IgA(sIgA)的含量以及血清中CD3+、CD4+、CD8+、NK细胞的数量,与正常儿童对照组比较,观察患儿各项指标的变化。结果患儿术前C3、C4、IgA、IgG、IgM的水平与术后1、6个月和对照组比较无明显差异(P>0.05),术前唾液中sIgA含量较对照组明显升高(P<0.01),术后逐渐下降,6个月时恢复正常。患儿术前CD4+、CD4+/CD8+及NK细胞分别较对照组明显降低(P<0.01),CD8+较对照组升高(P<0.05);术后6个月时CD4+、CD4+/CD8+及NK细胞数量较术前明显回升(P<0.01),与对照组比较无明显改变(P>0.05),CD8+数量较术前明显下降(P<0.01),与对照组比较无明显改变(P>0.05)。结论 OSAHS患儿较正常儿童免疫功能低下,扁桃体加腺样体切除术后6个月免疫功能恢复正常,切除扁桃体加腺样体不会降低OSAHS患儿免疫功能。Objective To explore the influence of tonsillectomy and adenoidectomy on immune function in children with obstructive sleep apnea hypopnea syndrome （OSAHS）. Methods 45 cases of OSAHS children were chosen to undergo tonsillectomy and adenoidectomy. Preoperative and postoperative 1, 6 months detections of serum C3, CA, IgA, IgG, IgM content and salivary IgA （sIgA） content and the number of serum CD3 ＋ , CD4＋ , CD8＋ , NK cells were compared with those of normal children to observe the change of various index. Results The comparison with the control group showed that preoperative C3, C4, IgA, IgG, IgM and CD3 ＋ had no significant difference （ P 〉 0. 05 ）, preoperative CD4 ＋ , NK cell and CD4＋ / CD8＋ were significantly lower （P 〈0. 01 ）, CD8 ＋ was higher （ P 〈 0. 05 ）, preoperative salivary IgA was significantly higher （ P 〈 0. 01 ）. Compared with preoperative index postoperative salivary sIgA decreased apparently （ P 〈 0. 01 ）, postoperative CD4＋ , CD4 ＋ / CD8 ＋ , NK cell rose up apparently （P 〈 0. 01 ） and CD8 ＋ decreased significantly （ P 〈 0. 01 ）. The comparison with the control group showed that postoperative various index returned to normal （ P 〉 0. 05 ） after 6 months. Conclusions OSAHS children have lower immune function, and the immune function may return to normal after6 months＇ tonsillectomy and adenoidectomy. Tonsillectomy and adenoidectomy will not depress the immune function of OSAHS children.

关 键 词：扁桃体切除术 阻塞性睡眠呼吸暂停低通气综合征 免疫功能 儿童 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]