学术论文

      学龄前儿童扁桃体和腺样体切除后对机体免疫功能影响的研究

      Study on the effects of tonsillectomy and adenoidectomy on the body's immune function of preschool children

      摘要:
      目的:探讨学龄前儿童扁桃体和腺样体切除后对机体免疫功能的影响。方法采用配对对照法,选取40例患有阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的学龄前儿童[平均年龄(4.5±1.2)岁],检测其扁桃体和腺样体切除前后不同时期(术前、术后1个月、术后3个月)外周静脉血中的白细胞、中性粒细胞、淋巴细胞、单核细胞、免疫活性细胞(总 T 淋巴细胞、总 B 淋巴细胞)、免疫球蛋白(IgA、IgG、IgM)和补体C3、C4的含量,并以年龄相匹配的20例健康儿童的上述免疫参数作为对照,进行比较分析。结果患儿术前、术后1个月、术后3个月与对照组两两比较,上述各免疫参数差异均无统计学意义(t =0.332、0.212、0.336、0.415、0.579、1.295、0.874、1.143、1.296、1.058、1.261,均 P >0.05),虽然术后1个月免疫活性细胞(总 T 淋巴细胞、总 B 淋巴细胞)、免疫球蛋白(IgA、IgG、IgM)和补体 C3、C4的含量较术前略有下降,但在正常范围内,术后3个月均恢复正常。结论学龄前儿童扁桃体和腺样体切除后不会抑制儿童免疫系统的发育,将其切除是可行的。
      Abstract:
      Objective To investigate the effects of tonsillectomy and adenoidectomy on the body's immune function of preschool children.Methods Using paired comparison method,40 preschool children with OSAHS[aver-age age (4.5 ±1.2)years]were selected.The peripheral venous blood's white blood cells,neutrophils,lymphocytes, monocytes,immune active cells(total T lymphocytes and total B lymphocytes),immunoglobulin(IgA,IgG,IgM)and the content of C3 and C4 levels in the different periods (after 1 month,3 months )before and after tonsillectomy and adenoidectomy were detected.And the immune parameters of 20 healthy children with matched age were selected as control group,the analysis comparison was conducted.Results In preoperative and postoperative 1 month,3 months compared with the control group,the above immune parameters had no statistically significant differences (t =0.332, 0.212,0.336,0.415,0.579,1.295,0.874,1.143,1.296,1.058,1.261,all P >0.05).At postoperative 1 month, the immune active cells(total T lymphocytes and total B lymphocytes),immunoglobulin (IgA,IgG,IgM)and the content of C3 and C4 levels declined slightly compared with preoperation,but within the normal range,back to normal at postoperative 3 months.Conclusion Tonsillectomy and adenoidectomy will not suppress the development of preschool children's immune systems,and the resection is feasible.
      作者: 孙余才
      Author: Sun Yucai
      作者单位: 济宁医学院附属医院耳鼻喉科, 山东省济宁,272100
      刊 名: 中国基层医药 ISTIC
      年,卷(期): 2017, 24(6)
      在线出版日期: 2017年3月29日