Effect of resection of adenoids and/or tonsil on the immune indexes in children with obstructive sleep apnea hypopnea syndrome / 中华耳鼻咽喉头颈外科杂志

ABSTRACT

Objective@#To study the effect on immune indexes in children with obstructive sleep apnea hypopnea syndrome (OSAHS) before and after resection of adenoid and/or tonsil.@*Methods@#A total of 100 children with OSAHS due to adenoid hypertrophy were enrolled in Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital 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 1st day before surgery, 4th day, 1 month, 3 months and 6 months after surgery to detect lymphoid subsets percentage (CD3+, CD4+,CD8+, CD4/CD8, CD19, NK) 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; and group C was a total of 22 cases hypertrophy of adenoid and tonsil after plasma ablation of adenoid and tonsil.In the baseline data, age, gender and other variables were analyzed by anova and chi-square test, repeated measurement anova was used for intra-group and inter-group comparison of observation indicators at different time points after operation, and independent sample t-test was used for comparison between the two groups at observation points 3 months after operation.@*Results@#(1) In group A, the percentage of CD19 lymphocytes before surgery was higher than that at 4th day after surgery, and the difference was statistically significant (21.85±6.20 vs.19.18±5.91, P<0.05). 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 (all P<0.05). 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 (all P<0.05). 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 (all P<0.05).In the 1st month after surgery, the percentage of CD8+T lymphocytes and CD19 lymphocytes were significantly different between those before surgery (all P<0.05). 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 (all P<0.05). At 4th day after surgery, the percentage of CD4+T lymphocytes in group B and C were lower than those in group A, and the differences were statistically significant (32.22±6.14, 32.36±6.87 vs. 36.36±5.19, all P<0.05); the other immune indexes were not statistically different among each group before and after surgery (P>0.05).@*Conclusions@#Resection of adenoid has no significant effect on the immune indexes in children with OSAHS. The children with OSAHS complicated with tonsil problems have immune index disorder before surgery. Surgery has a certain effect on the immune indexes of children with OSAHS in a short period of time, and tends to normal level after one month.