慢性扁桃体炎患者术前术后免疫功能变化的Meta分析  

Changes of immune function before and after chronic tonsillitis surgery: a Meta-analysis

作　　者：曲丹菊 张超[1] 苏吉利[1] 周倩 Qu Dan ju;Zhang Chao;Su Jili;Zhou Qian(Department of Otorhinolary-Head and Neck Surgery,the First Affiliated Hospital to and College of Clinical Medicine of Henan University of Science and Technology,Luoyang,Henan 471003,China)

机构地区：[1]河南科技大学临床医学院,河南科技大学第一附属医院耳鼻咽喉头颈外科,河南洛阳471003

出　　处：《感染．炎症．修复》2020年第2期98-104,共7页Infection Inflammation Repair

基　　金：河南省医学科技攻关计划资助项目(201504020)。

摘　　要：目的:采用Meta分析方法研究全扁桃体切除对慢性扁桃体炎患者机体免疫状态的影响。方法:以“慢性扁桃体炎”“手术治疗”“免疫功能”“tonsillitis”“immunology”“surgery”等作为主题词或关键词,在PUBMED、MEDLINE、EMBASE、Cochrane图书馆、中国生物医学文献光盘数据库等中外数据库中检索研究手术前后CD4+、CD8+和CD4+/CD8+比值变化的中文和英文文献,用WPS中Excel软件进行数据提取,RevMan5.3软件进行数据分析整合,通过Q检验法进行异质性检验,借助I2定量估计异质性大小,故设定α=0.10,增大检验效能。结果:慢性扁桃体炎患者术前CD4+、CD4+/CD8+比值较健康者低;CD8+与健康者比较没有明显差异。扁桃体切除术后3个月CD4+、CD4+/CD8+比值较术前提高;术后6个月CD4+比值较术前提高,CD4+/CD8+比值虽显示较术前提高,但由于异质性原因不明,样本量较小,仍需要大样本研究进一步证实;术后3个月、6个月CD8+与术前比较无明显差异。结论:扁桃体切除术对免疫系统没有损害作用,相反,它似乎能解除免疫系统受到的抑制,改善免疫反应。但由于缺乏对低年龄儿童的研究,故对于4岁以下儿童手术适应的掌握依然要严格。Objective:To analyze the effect of tonsillectomy on the immune state of patients with chronic tonsillitis by Meta analysis.Methods:With tonsillitis,immunology and surgery as descriptor or keyword,the Chinese and English documents studying the changes of CD4+,CD8+and CD4+/CD8+ratio before and after tonsillectomy in patients with chronic tonsillitis were retrieved from the database such as PUBMED,MEDLINE,EMBASE,Cochrane Library,CBMdisc,etc.The data were extracted with Excel software in WPS,and analyzed and integrated with RevMan5.3 software,the heterogeneity was tested by Q test,and quantitatively estimated with I2.Due to the small number of included data,α=0.10 was set to increase the test efficiency.Results:The CD4+and CD4+/CD8+ratio were significant lower in preoperative patients with chronic tonsillitis than in the healthy subjects,no marked difference existed on the proportion of CD8+.Three months after operation,the CD4+and CD4+/CD8+ratio in the peripheral blood of patients were higher than preoperation patients.Six months after surgery,the CD4+showed an significant increase in the peripheral blood of patients compared to preoperation.Although CD4+/CD8+ratio of patients with chronic tonsillitis 6 months after surgery were higher than those before surgery,but it should be further verified by more studies because of the small number of included literature and heterogeneity.For CD8+,no significant difference existed in patients with chronic tonsillitis at 3 and 6 months after surgery compared to that before surgery.Conclusions:Tonsillectomy does not weaken the body immunity,on the contrary,it seems to relieve the inhibition of immune system,and improve the immune response.However,due to the lack of researches on young children,the mastery of surgical adaptation for children under 4 years old is still strict.

关 键 词：扁桃体炎 慢性 扁桃体切除术 免疫功能 

分 类 号：R76[医药卫生—耳鼻咽喉科]