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[腺样体切除术联合扁桃体切除或部分扁桃体切除术后儿童的免疫变化]

[Postoperative changes of immunity in children undergoing adenoidectomy with tonsil ablation or with partial tonsillectomy].

作者信息

Zhou Chengyong, Dai Zhiyao

机构信息

Department of Otolaryngology, First Affiliated Hospital of PLA General Hospital, Beijing 100048, China.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2011 Nov;25(21):990-2.

Abstract

OBJECTIVE

To investigate the changes of humoral and cellular immune responses in children with OSAHS after adenoidectomy with tonsil ablation or partial tonsillectomy by a plasma-mediated radiofrequency-based device.

METHOD

Seventy children with OSAHS were enrolled in the study. According to the size of tonsils, they were divided into two groups: the adenoidectomy with tonsil ablation group and the adenoidectomy with partial tonsillectomy group. 4 ml of peripheral venous blood was drawn before and 1 month, 3 months after operation. Serum IgG, IgA, IgM levels and peripheral blood T lymphocyte subsets were measured.

RESULT

In the adenoidectomy with tonsil ablation group, the level of CD3+ and CD4+ /CD8+ ration were slightly increased, while the levels of CD4+ and CD8+ were slightly reduced at 1 month after operation as compared to preoperative period. However, in the adenoidectomy with partial tonsillectomy group, the levels of CD8+ at 1 month after operation were slightly increased compared with that in preoperative examination, while the CD3+, CD4+ level and the CD4+/CD8+ ratio were slightly reduced during the same period. In addition, the levels of serum immunoglobulins showed no significant difference between the two groups, and returned to the preoperative levels at 3 months after operation in both groups (P > 0.05).

CONCLUSION

The results of the present study indicate that the humoral and cellular immunity is not affected in children with OSAHS who undergo adenoidectomy with tonsil ablation or partial tonsillectomy using plasma-mediated radiofrequency ablation. The patients' immune functions can return to normal levels at 3 months after the surgery.

摘要

目的

探讨采用基于等离子体介导射频的设备行腺样体切除术联合扁桃体切除术或部分扁桃体切除术后儿童体液免疫和细胞免疫反应的变化。

方法

70例阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患儿纳入研究。根据扁桃体大小将其分为两组:腺样体切除术联合扁桃体切除术组和腺样体切除术联合部分扁桃体切除术组。术前及术后1个月、3个月采集4 ml外周静脉血。检测血清IgG、IgA、IgM水平及外周血T淋巴细胞亚群。

结果

腺样体切除术联合扁桃体切除术组术后1个月,与术前相比,CD3⁺和CD4⁺/CD8⁺比值略有升高,而CD4⁺和CD8⁺水平略有降低。然而,腺样体切除术联合部分扁桃体切除术组术后1个月CD8⁺水平较术前检查略有升高,而同期CD3⁺、CD4⁺水平及CD4⁺/CD8⁺比值略有降低。此外,两组血清免疫球蛋白水平差异无统计学意义,两组术后3个月均恢复至术前水平(P>0.05)。

结论

本研究结果表明,采用等离子体介导射频消融术行腺样体切除术联合扁桃体切除术或部分扁桃体切除术的OSAHS患儿的体液免疫和细胞免疫未受影响。术后3个月患者免疫功能可恢复至正常水平。

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