扁桃体及腺样体摘除术对6～12岁儿童免疫功能的影响

Influence of tonsillectomy and adenoid enucleation on immunological function of children aged 6 to 12

目的：探讨扁桃体、腺样体摘除术对6～12岁儿童免疫功能的影响。方法：选取30例6～12岁的慢性扁桃体炎和腺样体肥大患儿设为手术组,同期30例健康体检儿童设为对照组,观察手术组患儿手术前后免疫球蛋白Ig A、Ig G、Ig M、补体C3、C4浓度变化,及其与对照组差异,所有患儿随访半年,记录症状积分变化,并分析症状积分与各指标之间的相关性。结果：手术组术后Ig A浓度较术前显著下降（P〈0.01）,但与对照组比较,差异无统计学意义（P〉0.05）;Ig G、Ig M、补体C3、C4浓度手术前后无显著变化,且与对照组差异无统计学意义（P〉0.05）。术后半年,患儿症状积分较术前下降（P〈0.01）。相关性分析表明,症状积分与术前Ig G呈负相关（r=-0.910,P〈0.01）。结论：对6～12岁儿童行扁桃体及腺样体摘除术可有效改善临床症状,减少呼吸道感染次数,且不会降低机体自身免疫功能,值得临床推广。

Objective： To explore the influence of tonsillectomy and adenoid enucleation on the immunological function of children aged 6 to 12. Methods： A total of 30 children with chronic tonsillitis and adenoid hypertrophy were selected as surgery group while another 30 healthy children undergoing physical examination as control group. The concentration changes of immunoglobulin Ig A,Ig G and Ig M as well as complement C 3 and C4 before and after surgery in surgery group were observed and compared with those in control group. All children were followed up for half a year to record the symptom score changes and analyze the relevance between symptom score and each index. Results： After surgery,Ig A concentration decreased evidently than that before surgery in surgery group（ P〈0. 01）,but there was no significant difference between two groups（ P〉0. 05）. There was no significant difference in the concentration changes of Ig G and Ig M as well as C3 and C4（ P〉0. 05）,or between two groups（ P〉0. 05）. The symptom score decreased apparently half a year after surgery than before in surgery group（ P〈0. 01）. Relevance analysis showed that symptom score was in negative association with preoperative Ig G level（ r =- 0. 910,P〈0. 01）. Conclusion： Tonsillectomy and adenoid enucleation can effectively improve the clinical symptoms and reduce the infectious chances of respiratory tract without decreasing the autologous immunological function in children aged 6 to 12,thus deserving to be widely used in clinic.