Effects of adenotonsillectomy on immunoregulation in children with obstructive sleep apnea hypopnea syndrome

Abstract

Objective:To observe the effects of adenotonsillectomy on immunoregulation in children with obstructive sleep apnea hypopnea syndrome. Method:Thirty-six OSAHS children were recruited as an experimental group while 40 healthy children for the control group. Blood samples were collected from experimental group and control group. Tonsillectomy and adenoidectomy were performed under general anesthesia in the experimental group. Blood samples of the experimental group were collected at 4 days, 1, 3 and 6 months after operation, respectively. Lymphocyte subsets, NK cells and immunoglobulin were analysis in all patients. Result:①The expression of IgA in the experimental group was significantly lower than the control group before operation (P<0.01). No significant difference was found between the other groups (P>0.05). ②The percentage of CD4+ T cells and CD4+/CD8+ ratio in the experimental group were significantly lower than those in the control group before operation (P<0.01 or <0.05). The percentage of CD8+ T cells in experimental group was significantly higher than that in control group one day before operation (P<0.01). ③In the experimental group, the expression of IgG at 4 days and 1 month was significantly lower than that before operation (P<0.05). At 3 and 6 months after operation, IgA was significantly higher than that before operation, the difference was statistically significant (P<0.01 or <0.05). No significant difference was found between the other groups (P>0.05). ④The percentage of CD4+ T, CD3+ T and NK cells, CD4+/CD8+ ratio in the experimental group at post-operative 4 days were lower than those before operation, and the percentage of CD8+ T cells was CD4+/CD8+ ratio in 3 and 6 months after operation was higher than that before operation, and CD8+ T was lower than before operation,the difference was statistically significant (P<0.01 or <0.05). No significant difference was found between the other groups (P>0.05). Conclusion:①Compared with healthy children, OSAHS children have a certain degree of cellular and humoral immune disorders, accompanied by different levels of cellular and humoral immune function decline. ②The cellular and humoral immune function in children with obstructive sleep apnea hypopnea syndrome (OSAHS) decreased within 1 month, but recovered to healthy children at 6 months after operation. Adenoidectomy and tonsillectomy were helpful to restore the immune function of children with OSAHS.