Yan Yuyan, Song Yingluan, Liu Yingying, Su Jinzhu, Cui Li, Wang Juan, Geng Jiangqiao, Liu Xiaofeng, Shi Yanan, Quan Shan, Hang Aiping, Zuo Lujie
Department of Otolaryngology, Head and Neck Surgery, Children's Hospital of Hebei Province Affiliated to Hebei Medical University, Shijiazhuang city, Hebei Province, China.
Medicine (Baltimore). 2019 May;98(19):e15530. doi: 10.1097/MD.0000000000015530.
To investigate the short- and long-term impacts of adenoidectomy with/without tonsillectomy on the immune functions of young children < 3 years of age.This longitudinal prospective study included 40 pediatric patients (age <3 y) undergoing adenoidectomy with/without tonsillectomy for snoring and sleep apnea. Serum immunoglobulin IgA, IgG, IgM, complement C3, and C4 levels were measured for the status of humoral immunity; CD3+, CD4+, CD8+, CD4+/CD8+, CD19+, CD56+, CD3+CD4-CD8-, and CD3+CD4+CD8+ T cells were measured for the status of cellular immunity. Blood samples were taken at 3 time points: before surgery, 1 month after surgery (short-term), and 3 months after surgery (long-term). All patients were assessed for short-term outcome at 1-month postoperation, but only 30 patients were followed at 3 months after surgery. The incidence of recurrent respiratory tract infections and other immune-related conditions were recorded at each follow-up.The levels of IgA significantly decreased from the preoperative level at 1-month follow-up (P < .05), but still within normal range. No significant changes were found in the levels of IgA, IgG, IgM, C3, C4, CD3+, CD4+, CD8+, CD4+/CD8+, CD19+, CD56+, CD3+CD4-CD8-, and CD3+CD4+CD8+ T cell at 3-month follow-up in comparison with preoperative levels. There was also no episode of recurrent respiratory tract infection and other immune-deficiency conditions.Adenoidectomy with/without tonsillectomy may result in a reduction in individual antibodies in children <3 years of age, but did not show negative impacts on their immune functions. Also, the surgery does not lead to the increased risk of upper respiratory tract infection in these children.
探讨腺样体切除术联合或不联合扁桃体切除术对3岁以下幼儿免疫功能的短期和长期影响。这项纵向前瞻性研究纳入了40例因打鼾和睡眠呼吸暂停接受腺样体切除术联合或不联合扁桃体切除术的儿科患者（年龄<3岁）。检测血清免疫球蛋白IgA、IgG、IgM、补体C3和C4水平以评估体液免疫状态；检测CD3+、CD4+、CD8+、CD4+/CD8+、CD19+、CD56+、CD3+CD4-CD8-和CD3+CD4+CD8+ T细胞以评估细胞免疫状态。在3个时间点采集血样：手术前、术后1个月（短期）和术后3个月（长期）。所有患者在术后1个月评估短期结局，但术后3个月仅对30例患者进行随访。记录每次随访时复发性呼吸道感染及其他免疫相关疾病的发生率。IgA水平在术后1个月随访时较术前水平显著降低（P<0.05），但仍在正常范围内。与术前水平相比，术后3个月随访时IgA、IgG、IgM、C3、C4、CD3+、CD4+、CD8+、CD4+/CD8+、CD19+、CD56+、CD3+CD4-CD8-和CD3+CD4+CD8+ T细胞水平均无显著变化。也没有复发性呼吸道感染及其他免疫缺陷疾病的发作。腺样体切除术联合或不联合扁桃体切除术可能会导致3岁以下儿童个体抗体减少，但对其免疫功能没有负面影响。此外，该手术不会增加这些儿童上呼吸道感染的风险。
