切除扁桃体、腺样体对儿童唾液免疫球蛋白A的影响  

Effect of excision of tonsils and adenoids on salivary secretory immunoglobulin A in children

作　　者：周津徽 张欣[1] 王成禹 徐彧[1] ZHOU Jinhui;ZHANG Xin;WANG Chengyu;XU Yu(Department of Otolaryngology Head and Neck Surgery,the Affiliated Huai’an No.1 People’s Hospital of Nanjing Medical University,Huai’an 223300,China)

机构地区：[1]南京医科大学附属淮安第一医院耳鼻咽喉科,淮安223300

出　　处：《中国眼耳鼻喉科杂志》2021年第4期268-271,共4页Chinese Journal of Ophthalmology and Otorhinolaryngology

摘　　要：目的探讨切除扁桃体、腺样体对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患儿唾液分泌型免疫球蛋白A(SIgA)的影响及其临床意义。方法收集2017年1月~2018年1月在我科收治住院的行扁桃体、腺样体切除术OSAHS患儿100例,分别收集术前1 d,术后第2天、1个月、3个月患儿的唾液。同时收集在我院体检中心体检的100例健康儿童的唾液,采用酶联免疫吸附法检测唾液中SIgA,观察唾液SIgA水平在术后第2天、1个月、3个月的变化情况。结果扁桃体、腺样体切除术后第2天,患儿SIgA降低,与术前1 d相比差异有统计学意义(P<0.05);术后1个月升高,但仍较术前低,差异有统计学意义(P<0.05);术后3个月恢复正常,与术前1 d相比差异无统计学意义(P>0.05)。大儿童(6~14岁)和小儿童(3~5岁)之间各时间点SIgA差异均无统计学意义(P值均>0.05)。结论扁桃体、腺样体切除术后短期内可使OSAHS患儿SIgA水平降低,1个月后恢复但仍未达到正常,3个月后可恢复到正常水平;对大儿童、小儿童SIgA影响无明显差异。Objective To investigate the effect of excision of tonsils and adenoids on salivary secretory immunoglobulin A(SIgA) in children with obstructive sleep apnea hypopnea syndrome(OSAHS) and its clinical significance. Methods One hundred OSAHS patients accepted tonsillectomy and adenoidectomy from January 2017 to February 2018 in our hospital were involved. Their saliva were collected 1 day before surgery, 2 days after surgery, 1 month after surgery, and 3 months after surgery respectively. At the same time, the saliva of 100 healthy children in the physical examination center of our hospital were collected. The SIgA in saliva was detected by enzyme-linked immunosorbent assay(ELISA). The levels of SIgA were observed 2 days after surgery, 1 month after operation, and 3 months after operation respectively. Results The SIgA significantly decreased in patients on the 2 nd day after surgery compared with 1 day before surgery(P<0.05). It was elevated 1 month after operation but still lower than that before surgery and the difference was statistically significant(P<0.05). It returned to normal level after 3 months and there was no statistical significance compared with 1 day before surgery(P>0.05). Conclusions In the short-term after tonsillectomy and adenoidectomy, the level of SIgA was reduced, but it will recover after 1 month and return to normal level after 3 months. After the surgery, there was no significant difference of SIgA between patients aged from 6 to 14 years and patients aged from 3 to 5 years.

关 键 词：腺样体切除术 扁桃体切除术 免疫功能 分泌型免疫球蛋白A 儿童 

分 类 号：R766.9[医药卫生—耳鼻咽喉科]