| ObjectiveComparison of obstructive sleep apnea hypopnea syndrome(OSAHS)in children with changes in immune function related indicators before and after the surgery,so as to explore the impact of surgical intervention in children with OSAHS immune function,provide the basis for clinical treatment.MethodsSelect January 2013 ~ January 2014 50 cases of children with OSAHS in our hospital,were confirmed by overnight polysomnography monitor(PSG)diagnosis and surgical treatment after admission,as the observation group,the low-temperature plasma ablation adenoidectomy,based on 20 patients taking tonsil dissection,30 cases of children taken tonsil plasma ablation,respectively,as A,B groups.Respectively,before surgery 24 ~ 48 h,after 3 to 6 months collected peripheral blood lymphocyte subsets were detected and related immune indices,using flow cytometry lymphocyte subsets.Select the same year to our hospital for medical examination of 50 healthy children as a control group,gender,age and other general information matches the observation group,and exclusion of child-related disease,peripheral venous blood collected determination of lymphocyte subsets and related immune index.Changes in the indicators of OSAHS children before and after surgery,and compared with a control group of healthy children.Results1.OSAHS children before surgery 50 cases of peripheral blood CD3 + T cell percentage compared with control group(70.82 ± 7.02 VS 72.17 ± 7.45),was not statistically significant(p> 0.05);preoperative peripheral blood CD4 + T cells,CD8 + T cells,NK cells and the percentage of CD4 + / CD8 + ratio compared with control group(26.61 ± 5.64 vs 37.73 ± 5.92,49.11 ± 5.72 vs 32.96 ± 6.12,41.77 ± 3.84 vs 65.62 ± 3.69,0.68 ± 0.35 vs 1.42 ± 0.51),the difference was statistically significant(p <0.05).2.OSAHS children before surgery peripheral blood IgA,C3 content compared with control group(2.41 ± 0.53 vs 1.52 ± 0.34,1.68 ± 0.51 vs 1.02 ± 0.36),the difference was statistically significant(p <0.05);and IgG,IgM,C4 level with the control group,the difference was not statistically significant(p> 0.05).3.OSAHS children before surgery serum IL-4,IL-6,IL-10,IFN-y content compared with control group(2.53 ± 0.68 vs 1.46 ± 0.63,3.68 ± 1.12 vs2.57 ± 1.04,3.49 ± 1.25 vs 3.01 ± 1.02,4.37 ± 1.43 vs 2.76 ± 1.28),the difference was statistically significant(p <0.05);and IL-2,TNF-a content with the control group,the difference was not statistically significant(p> 0.05).4.A group of patients with OSAHS after CD4 + T cells,NK cells and the percentage of CD4 + / CD8 + ratio(35.11 ± 5.58,46.15 ± 3.55,0.93 ± 0.36),significantly higher than the preoperative(28.17 ± 5.42,42.96 ± 3.69 before,0.74 ± 0.41),while the percentage of CD8 + T cells(39.07 ± 5.81)was significantly higher than the preoperative(45.31 ± 5.72),the difference was statistically significant(p <0.05);group B OSAHS postoperatively CD4 + T cells,NK cells and the percentage of CD4 + / CD8 + ratio was(33.97 ± 5.67,47.10 ± 3.66,0.95 ± 0.46),significantly higher than the preoperative(28.25 ± 5.45,43.02 ± 3.45,0.72 ± 0.42),and the percentage of CD8 + T cells(35.37 ± 5.33)was significantly lower than the preoperative(48.31 ± 5.69),the difference was statistically significant(p <0.05).5.A OSAHS group were peripheral blood IgA,C3 content(2.57 ± 0.55,1.87 ± 0.58),higher than the preoperative(2.36 ± 0.49,1.65 ± 0.54),the difference was statistically significant(p <0.05),but the difference was not statistically significant(p> 0.05)before IgG,IgM,C4 levels and the preoperative;group B OSAHS postoperatively IgA,C3 content(2.94 ± 0.41,2.46 ± 0.45),higher than the preoperative(2.34 ± 0.48,1.68 ± 0.52),the difference was statistically significant(p <0.05),but the difference was not statistically significant(p former IgG,IgM,C4 levels and intraoperative(P> 0.05).6.A group OSAHS postoperatively IL-4,IL-6,IL-10,IFN-y content,respectively(3.10 ± 0.77,4.28 ± 1.31,4.16 ± 1.28,5.23 ± 1.57),were higher than preoperative(2.52 ± 0.68,3.63 ± 1.12,3.48 ± 1.17,4.37 ± 1.46),the difference was statistically significant(p <0.05),and IL-2,TNF-a content difference compared with before surgery was not statistically significant(p> 0.05);postoperative patients with OSAHS group B IL-4,IL-6,IL-10,IFN-y content was(3.46 ± 0.67,4.70 ± 1.06,4.02 ± 1.03,4.89 ± 1.32),higher than the preoperative(2.48 ± 0.74,3.28 ± 1.16,3.15 ± 1.24,3.90 ± 1.48),the difference was statistically significant(p <0.05),and IL-2,TNF-a difference compared with before surgery does not have the content statistically significant(p> 0.05).Conclusions1.OSAHS children before surgery CD4 + T lymphocytes,NK cells and the percentage of CD4 + / CD8 + ratio decreased,CD8 + T lymphocyte percentage increased,suggesting OSAHS may reduce cellular immune function of children;and IgA,C3,IL-4,IL-6,IL-10,IFN-y content increased,indicating that OSAHS also affect the humoral immune function of children,the body oxidative stress and systemic inflammation.2.After 3 months after surgical intervention,the immune function in children with OSAHS index,comparing with the preoperative,changed significantly.While immune function is getting a little higher,indicating that surgical intervention in the short term does not enhance or improve immune function impairment in children.3.After different surgical intervention,comparatives between Group A and group B were not statistically significant,indicating that the trend of surgical treatment of patients with OSAHS immune function is not decisive effect. |
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