| Objective:To study the effect on immune function in children with OSAHS before and after resection of adenoid and/or tonsil by comparing the percentage of lymphocyte subsets and the level of immunoglobulin in peripheral blood of children with OSAHS.Methods:A total of 100 children with OSAHS due to adenoid hypertrophy were enrolled in the Otorhinolaryngology department of Second Hostipal of Dalian Medical University from December 2016 to December 2018.Some cases were complicated with tonsil hypertrophy or chronic tonsillitis.6 ml of fasting peripheral venous blood were collected from all subjects at the 1th day before surgery,4th day,1 month ? 3 months and 6 months after surgery to detected lymphoid subsets(CD3+,CD4+,CD8+,CD4/CD8,CD19,NK)percentage and level of immunoglobulin(IgG,IgA,IgM).Grouping: group A was a total of 51 cases with adenoid hypertrophy after Adenoid plasma ablation;group B was a total of 27 cases with adenoid hypertrophy and chronic tonsillitis after plasma ablation of adenoid and tonsil;group C was a total of 22 cases hypertrophy of adenoid and tonsil after plasma ablation of adenoid and tonsil.Statistical methods were used to compare and analyze the differences in preoperative and postoperative immunological indexes in each group and among the three groups.Results:1.In group A,the percentage of CD19 lymphocytes before surgery(19.18±5.91)was higher than that at 4th day after surgery(21.85±6.20),and the difference was statistically significant(p=0.000).The other immune indexes were not statistically different before and after surgery(p>0.05).2.In group B,the percentage of CD19 lymphocytes,CD3+ T lymphocytes,CD8+ T lymphocytes and the level of IgG at 4th day after surgery were significantly different between those before surgery(p=0.000,0.002,0.002,0.000).The percentage of CD19lymphocytes(24.80±6.51)was higher than that before surgery(19.65±4.39);the percentage of CD3+ T lymphocytes,CD8+ T lymphocytes and the level of IgG(64.74±5.87,24.99±4.57,9.84±2.55)were less than those before surgery(67.99±4.79,26.74±4.38,11.07±2.38).At the 1st month after surgery,the percentage of CD3+ T lymphocytes,CD8+ T lymphocytes,CD19 lymphocytes and the level of IgG were significantly different between those before surgery(p=0.000,0.024,0.002,0.000).The percentage of CD3+ T lymphocytes and the CD8+ T lymphocytes at 1st month after surgery(71.17±4.87,28.21±5.26)were higher than those before surgery(67.99±4.79,26.74±4.38);the percentage of CD19 lymphocytes and the level of IgG at 1st month after surgery(17.03±3.84,9.88±1.95)were less than those before surgery(19.65±4.39,11.07±2.38);the other immune indexes were not statistically different before and after operation(p>0.05).3.In group C,the percentage of CD19 lymphocytes and the CD3+ T lymphocytes at 4th day after surgery were significantly different between those before surgery(p=0.028,0.028);the percentage of CD19 lymphocytes(24.37±7.37)was higher than that before surgery(20.44±5.84);the percentage of CD3+ T lymphocytes(65.13±8.21)was less than that before surgery(67.88±6.75).In the 1st month after surgery,the percentage of CD8+ T lymphocytes and CD19 lymphocytes were significantly different between those before surgery(p=0.049,0.000);the percentage of CD8+ T lymphocytes(27.42±6.83)was higher than that before surgery(25.95 ± 6.77);the percentage of CD19 lymphocytes(16.56±4.19)was less than that before surgery(20.44±5.84);the other immune indexes were not statistically different before and after operation(p>0.05).4.Among three groups: The percentage of CD4+ T lymphocytes,the levels of IgG and IgA before surgery between group A and Group B were statistically significant(p=0.050,0.030,0.020);the percentage of CD4+ T lymphocytes in group A(37.24±6.44)was higher than that in group B(33.39±6.59)and the levels of IgG and IgA in group B(11.07±2.38,1.53±0.80)were higher than those in group A(9.63±2.41,1.13±0.53).At4 th day after surgery,the percentage of CD4+ T lymphocytes in group B and C(32.22±6.14,32.36±6.87)were lower than those in group A(36.36±5.19),and the differences were statistically significant(p=0.011,0.025);the other immune indexes were not statistically different among each group before and after surgery(p>0.05).Conclusion:1.Simple resection of adenoid had no significant effect on the immune function of children.2.Simultaneous removal of adenoids and tonsils has a certain impact on children's immune function in a short period of time,and can gradually recover after one month. |
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