Effects Of Operation Intervention On The Changes Of The T-lymphocytes Subgroups And The Activity Of NK Cells In Children With Obstructive Sleep Apnea Hypopnea Syndrome

Objective To study the changes of the T-lymphocytes subgroups and the activity of NK cells in children with obstructive sleep apnea hypopnea syndrome before and after surgical intervention, and evaluate the influence of surgical intervention on immune function of children with OSAHS.Methods Select 36 patients with OSAHS diagnosed by PSG overnight from March to June in 2010, collected blood simples of 24～48 h before surgery, Tonsil, adenoidectomy after 3 months and 6 months follow-up,and selected 30 healthy children who was age-and gender-matched and excluded from related diseases. Detect the percentage of the CD3⁺, CD4⁺, CD8⁺, the ratio of CD4⁺/CD8⁺, the distribution of NK cell activity by FCM in peripheral blood, and record the monitoring results of the minimum LSaO₂, AHI in PSG of children with OSAHS before surgery, 3 months after surgical intervention and 6 months follow-up at the same time. Compared with healthy children separately.Results (1) Compared with healthy children:â‘ The percentage of CD3⁺, CD4⁺ lymphocytes, the ratio of CD4⁺/CD8⁺ and the distribution of NK cell activity in newly diagnosed OSAHS children were decreased markedly (P<0.01), while the percentage of CD8⁺ lymphocytes was increased significantly (P<0.01).â‘¡3 months after treatment, the percentage of the CD3⁺, CD4⁺, CD8 ⁺, the ratio of CD4⁺/CD8⁺ and the distribution of NK cell activity were significantly different (P<0.01), and there is no significant difference with children (P>0.05).â‘¢After 6 months follow-up, there were no significant differences in the detected indices between the patients and the healthy children (P>0.05).â‘£LSaO₂ is significant lower, and the AHI is higher in the preoperative child with OSAHS.⑤3 months after treatment, LSaO₂ is higher and the AHI is lower.â‘¥After 6 months follow-up, there were no significant differences in the the minimum LSaO₂ and AHI (P>0.05). (2) Linear regression analysis indicated that the percentage of the CD3⁺, CD4⁺, CD8⁺, the ratio of CD4⁺/CD8⁺ and the distribution of NK cell activity were linearly related with the LSaO₂ and AHI. As the percentage of LSaO₂ incresed, the percentage of the CD3⁺, CD4⁺, the ratio of CD4⁺/CD8⁺ and the distribution of NK cell activity increased, while the CD8⁺ lymphocytes decreased. As the percentage of LSaO₂ decresed, the percentage of the CD3⁺, CD4⁺, CD8⁺, the ratio of CD4⁺/CD8⁺ and the distribution of NK cell activity decreased.Conclusion OSAHS may influence the immune system of the children, the patients were still in the cellular immune deficiency state 3 months later after the Tonsil, adenoidectomy, while 6 month after adenotonsillectomy, the Immune imbalance of children with OSAHS can be completely reversed, the long-dated effect of operation can be affirmed. There were linear relation between the CD3⁺, CD4⁺, CD8⁺, the ratio of CD4⁺/CD8⁺, the distribution of NK cell activity and the minimum LSaO₂ ,AHI which can reflect the condition of the disease. The minimum LSaO₂, AHI may be impact factors in the cellular immune function of children.