合并变应性鼻炎的阻塞性睡眠呼吸暂停低通气综合征儿童免疫功能检测及分析

目的检测阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并变应性鼻炎(AR)的儿童的细胞免疫及体液免疫功能,分析AR对OSAHS患儿免疫功能的影响。方法收集51例OSAHS患儿,按照是否合并AR分为OSAHS合并AR组(OSA+AR组)和单纯OSAHS组(OSA组)两组,其中OSA+AR组根据AR程度又分为轻、中、重三个亚组。检测各组患儿的体液免疫与细胞免疫指标,分析两组组间及OSA+AR组组内免疫功能的差异。结果与正常值相比,两组患儿CD3+T细胞、CD4+T细胞及CD4+/CD8+比值均显著降低,IgG、IgA、IgM含量均显著升高,差异有统计学意义(P0.05)。两组患儿组间相比:OSA+AR组患儿IgA含量、IgE含量比OSA组高,差异有统计学意义(P0.05)。随着合并AR患儿的过敏程度加重,CD8+T细胞所占比例逐渐升高,且轻度组与中、重度组相比,差异均有显著性意义(P0.05);CD4+/CD8+比值逐渐降低,且轻度组与重度组相比,差异有显著性意义(P0.05);CD4+T细胞所占比例、IgA含量有降低趋势,IgE含量有升高趋势,但无显著统计学意义(P0.05)。结论 OSAHS患儿的细胞免疫及体液免疫功能均有一定程度下降,其中合并AR的患儿免疫功能下降更明显,AR在OSAHS患儿的免疫功能下降中发挥重要作用。     

急性分泌性中耳炎调节性T细胞及T淋巴细胞亚群的分析

目的 检测急性分泌性中耳炎(SOM)患者外周血调节性T细胞及淋巴细胞亚群的变化,综合分析免疫因素在其发病中的作用.方法 以流式细胞术检测38例上感后诱发急性SOM患者,30例健康献血者外周血中CD3+、CD4+、CD8+、NK细胞、B淋巴细胞百分比,CD4 +/CD8+比值,CD4+ CD25+调节性T细胞百分比以及T淋巴细胞亚群的计数.结果 患者组CD3+ CD8+、NK细胞的百分比明显低于正常对照组(P＜0.05);CD4+/CD8+、B淋巴细胞比例明显高于正常对照组(P＜0.05);正常对照组Tregs占CD4 +T淋巴细胞的比例为(6.695±1.09)％,患者组占CD4 +T淋巴细胞的比例为(12.82±4.56)％,与正常对照组比较差异有统计学意义(P＜0.05);两组间CD3+、CD4+细胞比例,差异无统计学意义(P＞0.05);正常对照组及患者组外周血CD3+、CD3+ CD4+、CD3+ CD8+T淋巴细胞计数,两组之间差异无显著性(P＞0.05).结论 急性分泌性中耳炎患者存在着免疫失调,CD4+/CD8+下降,Tregs比例异常增高,说明免疫异常在SOM的发病中起一定的作用.     

喉癌围手术期细胞免疫功能改变的意义

目的:了解喉癌患者围手术期细胞免疫的状况及手术相关因素对患者细胞免疫的影响;了解T淋巴细胞水平与喉癌临床特征、病程进展的关系.方法:应用SAP法检测喉癌术前2d及术后12d外周血CD3+、CD4+、CD8+细胞水平及CD4+/CD8+比率的改变,并联系临床分期、淋巴结转移、复发综合分析.结果:喉癌患者CD3+、CD4+、CD8+细胞水平及CD4+/CD8+比正常对照组明显下降;术后CD3+、CD4+、CD8+有进一步下降的倾向.晚期喉癌患者CD4+细胞水平、CD4+/CD8+比率明显下降(P＜0.05).淋巴结转移者CD4+/CD8+亦下降,CD8+细胞水平却相对升高;复发患者的CD8+细胞水平相对提高.结论:喉癌患者T淋巴细胞免疫功能低下,全麻、手术创伤及术后复合因素是喉癌术后免疫功能进一步低下的原因.CD4+、CD8+细胞水平及CD4+/CD8+比率是表明喉癌患者病期进展、淋巴结转移、复发的免疫学指标.围手术期需行免疫治疗.     

鼻炎康片联合地氯雷他定对变应性鼻炎患者T细胞亚群及血清IL-4、IL-8、FN-γ和IgE水平的影响

目的观察鼻炎康片联合地氯雷他定对变应性鼻炎患者外周血T细胞亚群及血清IL-4、IL-8、FN-γ、IgE水平的影响。方法我院2014年7月~2016年8月收治的83例变应性鼻炎患者随机分为两组,包括中单一组41例,仅予地氯雷他定治疗;联合组42例,予地氯雷他定加鼻炎康片治疗。10天为1疗程,连续治疗3疗程。比较观察治疗前后两组患者症状,检测外周血T淋巴细胞亚群CD3~+、CD4~+及CD8~+T细胞、CD4~+/CD8~+T细胞比值,血清IL-4、IL-8、FN-γ、IgE水平。疗程结束后,比较分析两组患者疗效及各项检测值。结果联合组总有效率95.24%(40/42),明显高于单一组的73.17%(30/41),P0.05。两组患者治疗前外周血T细胞亚群及相关比值、细胞因子与TgE水平比较P0.05。治疗结束后,两组CD3~+T细胞水平均无明显变化,但CD8~+T细胞水平升高,CD4~+/CD8~+T细胞比值、CD4~+T细胞水平均下降,但联合组CD8~+T细胞水平明显高于单一组,CD4~+/CD8~+T细胞比值、CD4~+T细胞水平则均低于单一组(P0.05);两组血清IL-4、IL-8、IgE水平均下降,FN-γ水平上升,但联合组IL-4、IL-8、IgE水平明显低于单一组,FN-γ水平明显高于单一组,P均0.05。两组不良反应发生率比较P0.05。结论地氯雷他定联合鼻炎康片疗法可有效降低变应性鼻炎患者血清IL-4、IL-8、IgE水平及外周血CD4~+T细胞数与CD4~+/CD8~+T细胞比值,提高FN-γ和CD8~+T细胞水平,效果更为显著而且安全性高。     

获得性免疫缺陷综合征合并慢性扁桃体炎患者Th1及Treg应答水平及意义

目的　探讨获得性免疫缺陷综合征（acquired immunodeficiency syndrome,AIDS）合并慢性扁桃体炎患者外周血和扁桃体组织中Th1/Treg应答情况。方法  采用RT-PCR检测了外周血和扁桃体T-bet /Foxp3的表达;同时采用免疫组织化学法检测T-bet/Foxp3以及CD4/CD8细胞的数量;采用全血胞内细胞因子染色方法,分析CD4+IFN-γ+T/CD4+CD25+ Foxp3+细胞表达水平。结果  FACS检测AIDS伴慢性扁桃体炎患者CD4+IFN-γ+T细胞表达（20.65±7.14）%显著低于健康对照（39.13±13.30）%和慢性扁桃体炎患者（36.89±10.05）%;CD4+CD25+Foxp3+细胞表达（7.38±2.63）%则明显高于健康对照（4.31±2.14）%和慢性扁桃体炎患者（4.79±2.23）%;CD4 细胞计数（104.5±60.96）显著低于健康对照（663.9±170.3）和慢性扁桃体炎患者（546.4±151.9）;CD8细胞计数（580.5±130.7）显著高于健康对照（364.7±69.85）和慢性扁桃体炎患者（443.0±150.5）;RT-PCR检测AIDS伴慢性扁桃体炎患者T-bet表达（4.831±2.61）显著低于健康对照（20.12±11.31）和慢性扁桃体炎患者（9.83±3.54）;Foxp3表达（102.5±47.42）显著高于健康对照（57.28±25.19）;免疫组化检测AIDS伴慢性扁桃体炎患者扁桃体组织中T-bet表达（80.20±2.20）显著高于慢性扁桃体炎患者（31.9±2.82）;Foxp3表达和慢性扁桃体炎患者差异无统计学意义;CD4细胞 (42.09±4.09）显著低于慢性扁桃体炎患 者（80.93±3.42）;CD8细胞（80.45±2.81）显著高于慢性扁桃体炎患者（37.57±3.11）。结论　患者外周血和扁桃体组织中存在明显不同的Th1/Treg免疫反应,Th1/Treg失衡在AIDS伴慢性扁桃体炎患者致病机制中起着重要作用。     

CD4~+、CD8~+T细胞及IL-2、IL-6与急性分泌性中耳炎的关联性及临床意义研究

目的探究急性分泌性中耳炎患者外周血和中耳积液中CD4+、CD8+T细胞及细胞因子IL-2、IL-6活性特征。方法以我院收治的47例急性分泌性中耳炎患者为观察组,48例健康体检人群为对照组,对比分析两组外周血CD4+、CD8+T细胞百分比及IL-2、IL-4及IL-6水平及CD4+/CD8+与中耳积液IL-2、IL-6活性的相关性。结果观察组患者外周血CD4+、CD8+T细胞数值及CD4+/CD8+比值均显著高于对照组(P0.001)。血清IL-2、IL-4及IL-6水平组间比较比较无统计学意义(P0.05),但观察组患者中耳积液IL-2、IL-6水平显著高于两组研究对象外周血中的相应指标水平,且中耳积液IL-2、IL-6与患者外周血CD4+/CD8+比值呈正相关趋势,r分别为=0.431(P0.001)与0.462(P0.001)。结论急性分泌性中耳炎患者外周血CD4+、CD8+T细胞及中耳积液IL-2、IL-6水平显著升高,为本病发病机制研究提供了相关线索。     

尘螨滴剂治疗儿童过敏性鼻炎的临床效果及对患儿机体免疫功能影响的研究[理论著]

目的　研究尘螨滴剂治疗过敏性鼻炎患儿的临床效果及对患儿机体免疫功能的影响。方法　随机选取2016年8月～2018年8月我院儿童过敏性鼻炎患儿600例，随机分为2组：对照组，300例，口服盐酸西替利嗪滴剂及氮卓斯汀喷鼻治疗组；研究组，300例，口服盐酸西替利嗪滴剂及氮卓斯汀喷鼻治疗基础上舌下含服尘螨滴剂治疗组，统计分析两组患儿的临床症状评分、用药评分、嗜酸性粒细胞（Eos）计数、临床疗效、免疫球蛋白水平、机体免疫功能、不良反应发生情况。结果　两组患儿治疗后的临床症状评分、用药评分、Eos计数均显著低于治疗前（P <0.05）；治疗前两组患儿的临床症状评分、用药评分、Eos计数之间的差异均不显著（P >0.05），治疗后研究组患儿的临床症状评分、用药评分、Eos计数均显著低于对照组（P <0.05）。研究组患儿治疗的总有效率96.7%（290/300），显著高于对照组83.3%（250/300）（P <0.05）。两组患儿治疗后的血清特异性IgE（sIgE）、总IgE（T-IgE）水平均显著低于治疗前（P <0.05），血清sIgG4水平均显著高于治疗前（P <0.05）；治疗前两组患儿的血清sIgG4、sIgE、T-IgE水平之间的差异均不显著（P >0.05），治疗后研究组患儿的血清sIgG4水平显著高于对照组（P <0.05），血清sIgE、T-IgE水平均显著低于对照组（P <0.05）。两组患儿治疗后的CD3+、CD4+、CD4+/CD8+均显著高于治疗前（P <0.05），CD8+均显著低于治疗前（P <0.05）；治疗后研究组患儿的CD3+、CD4+、CD4+/CD8+均显著高于对照组（P <0.05），CD8+显著低于对照组（P <0.05），但治疗前两组患儿的CD3+、CD4+、CD8+、CD4+/CD8+之间的差异均不显著（P >0.05）。两组患儿的不良反应发生率6.7%（20/300）、10.0%（30/300）之间的差异不显著（P >0.05）。结论　尘螨滴剂治疗儿童过敏性鼻炎的临床效果好，能够有效改善患儿机体免疫功能。     

儿童阻塞性睡眠呼吸暂停低通气综合征手术前后睡眠分期比例的变化分析

目的 探讨腺样体、扁桃体手术对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患儿睡眠分期比例的影响。方法 将我科2009年41例OSAHS患儿术前、术后均行睡眠监测,对睡眠分期比例进行统计学分析比较。结果 整夜多导睡眠监测结果显示,该组患儿术前、术后Ⅰ期睡眠比例(8.67±5.63% vs 7.26±5.70%)、Ⅱ期睡眠比例(43.17±10.08% vs 45.91±9.50)、慢波睡眠比例(30.15±8.50% vs 30.98±9.84%)、快动眼睡眠的比例(18.03±4.90% vs 15.83±6.55%),差异无统计学意义(P＞0.05)。结论 OSAHS患儿通过接受腺样体、扁桃体手术治疗,其术前、术后睡眠分期比例差异无统计学意义。     

消瘤汤治疗鼻内翻性乳头状瘤的疗效及其作用机理研究

目的 观察消瘤汤对鼻内翻性乳头状瘤术后复发与恶变的抑制作用及对宿主细胞免疫功能的影响.方法 鼻内翻性乳头状瘤患者60例,术后随机分为治疗组和对照组,每组各30例.治疗组术后服消瘤汤半年,对照组不用药物治疗,均随访8个月以上,观察病变复发和恶变情况.分别在术前及术后半年,以流式细胞仪检测患者外周血T淋巴细胞亚群及NK细胞活性,观察消瘤汤对宿主细胞免疫功能的影响.结果 治疗组复发2例（2/30,6.7%）,对照组复发8例（8/28,28.6%,其中3例存在轻至中度不典型增生）,差异具有统计学意义（P＜0.05）.与术前检测结果比较,治疗组的CD3^＋、CD4^＋T细胞及NK细胞比例升高,CD8^＋T细胞比例降低,对照组的CD3^＋、CD4^＋T细胞及NK细胞比例均降低,而CD8^＋T细胞比例升高.结论 消瘤汤可降低鼻内翻性乳头状瘤患者的术后复发率,并通过改善宿主细胞免疫功能而起到抑制其复发与恶变的作用.     

睡眠呼吸暂停综合征患者T细胞、NK细胞功能的研究

目的:检测睡眠呼吸暂停综合征(SAS)患者外周血T 淋巴细胞、NK细胞的变化,探讨SAS对细胞免疫功能的影响.方法:应用APAAP桥联酶标法测定外周血淋巴细胞表型.结果:SAS患者组CD3+细胞与正常对照组差异无显著性(P＞0.05)[ WTBZ〗,CD4+、CD4+/CD8+、CD16+、CD25+细胞SAS组均低于正常对照组,而CD8+ 细胞高于正常对照组(P＜0.05,P＜0.01).结论:SAS 患者免疫功能明显降低.     

腺样体扁桃体切除术对阻塞性睡眠呼吸暂停低通气综合征儿童生活质量的影响

目的　探讨腺样体扁桃体和（或）切除术对阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患儿生活质量的影响。方法　对OSAHS患儿行疾病特异性生活质量调查表（OSA-18）,分析术前、术后结果差异,评估生活质量变化。结果　246例患儿临床症状均缓解,OSA-18总分由（64.80±8.95）降至（30.11±4.49）,差异具有统计学意义（P <0.01）。生活质量改善总体有效率达99.60%,睡眠障碍、全身症状、对监护人的影响显著改善。结论　腺样体和（或）扁桃体切除术能够直接解除呼吸道梗阻,提高患儿睡眠质量、生活质量,可作为儿童OSAHS的主要治疗手段。     

Increased percentage of T cells with the expression of CD127 and CD132 in hypertrophic adenoid in children with otitis media with effusion

The hypertrophic adenoid may promote chronic suppurative otitis media in children as it fulfills its immune function. The number of lymphocytes in the adenoid and their cooperation in the immune response depend of on their proliferation and migration to the effector sites. Interleukin 7 (IL-7) is essential for the normal development and function lymphocytes. IL-7 plays pivotal role for activation and proliferation of T and B cells. The heterodimeric interleukin-7 receptor (IL-7R) is composed of the IL-7Rα (127) and the common cytokine receptor γc (CD132). The aim of this study was to evaluate the percentage of lymphocytes T (CD4⁺ and CD8⁺) with IL-7R (CD127 and CD132) expression in hypertrophic adenoid in children suffering with otitis media with effusion for a?duration of 3 months. Adenoid excised due to hypertrophy with or without chronic otitis media with effusion was used as study material. CD4⁺ CD127⁺, CD4⁺132⁺, CD8⁺CD127⁺ and CD8⁺CD132⁺ cell subpopulations were identified using monoclonal antibodies and flow cytometry. The percentage of CD4⁺ and CD8⁺ T cells with CD127 receptor expression in hypertrophic adenoid of children with otitis media with effusion was statistically significantly higher than in hypertrophic adenoid group. The percentage of CD4⁺ T cells with CD132 expression in the study group was statistically significantly higher than in the reference group. The percentage of CD8⁺ T cells with CD132⁺ expression was not statistically different in both groups. The increased percentage of T lymphocytes with IL-7R expression (CD127 and CD132) in hypertrophic adenoid seems to influence the quantity of lymphocytes and upset the immunological function of tonsils which can influence the course of otitis media with effusion.     

The correlation of immunologic derangement and juvenile recurrent parotitis: an investigation of the laboratory immunological observation

Abstract

Background: Juvenile recurrent parotitis (JRP) is defined as recurrent parotid inflammation, generally associated with nonobstructive sialectasis of the parotid gland. In addition, the etiology remains unclear, probably immunologically mediated.

Aim: The purposes of the present study were to report the relationship between JRP and immune function from the measurement of the JRP patients’ immunoglobulins and T-lymphocyte subset.

Methods: Immunologic assay from 2014 to 2017 of 100 children diagnosed with JRP at Shanghai Ninth Hospital compared with the 100 normal children by age.

Results: The CD4 level of JRP children aged >6 years was significant lower than the one of JRP preschool children (p?<?.05), while the IgG level was significant higher than the one of the JRP preschool children (p?<?.05). In comparison with the normal children, the value of CD8 T cells, immunoglobulin G (IgG), immunoglobulin E (IgE), immunoglobulin A (IgA) and C3 (p?<?.01) of JRP children was significant higher, while the value of CD4 T cells was lower (p?<?.01) in spite of age. What is more, the value of CD8 T cells of JRP preschool children was much significant higher than the one of the normal preschool children (p?<?.01).

Conclusion: The immune function of JRP patients may become disorder: the suppression cellular immune function and inadequate humoral immune expression.     

Reorganization of sleep architecture after surgery for OSAHS

Conclusion. Genioglossus advancement and hyoid suspension (GAHM) plus uvulopalatopharyngoplasty (UPPP) can decrease the apnea hypopnea index (AHI) and arousal index, especially respiratory-related arousals. Correspondingly, sleep architecture is reorganized, which is expressed postoperatively as an increase in slow wave sleep and a decrease in lighter sleep. Objective. To explore the reorganization of sleep patterns after GAHM plus UPPP for severe obstructive sleep apnea hypopnea syndrome (OSAHS). Patients and methods. GAHM plus UPPP was performed on 31 patients with severe OSAHS (AHI>40). The postoperative follow-up was 6 months. Results. The AHI was reduced from 65.93±23.83 preoperatively to 28.58±29.11 postoperatively. The arousal index was reduced from 56.00±18.78 to 41.97±20.73, and the respiratory arousal index was reduced from 35.44±21.57 to 22.63±21.99. No significant change was seen in the spontaneous arousal index (preoperative, 20.56±12.97; postoperative, 19.34±10.29). The percentage of REM sleep during the total sleep time (TST) increased from 10.53±9.13% to 13.92±6.76%, and the S3+S4 percentage of TST increased from 3.07±3.01% to 7.09±6.83%. Correspondingly, the S1+S2 percentage of TST decreased from 86.53±9.28% to 78.89±8.89%.     

Lymphocyte subpopulations in middle ear effusions

The aim of this study was to identify lymphocytes subpopulations in 55 middle ear effusions and peripheral blood samples from 33 children undergoing myringotomy for otitis media with effusion. CD3+, CD4+, CD8+, CD19+ and NK cell populations were investigated using three-colour monoclonal antibody and flow cytometry to quantitative estimation. CD3+ cells were the predominant cell type in effusions (mean 63.3%). Percentage CD4+, CD8+ cells and CD4+/CD8+ ratio was significantly higher in middle ear effusions than in blood. Lymphocyte subset was compared between 22 pairs of effusions from each patient. Percentage of each cells did not differ significantly. The results of this study indicate local regulation of lymphocyte profile in middle ear effusions and the same stadium of immune response in two ears of the same patient.     

阻塞性睡眠呼吸暂停低通气综合征患儿扁桃体腺样体切除术后机体免疫功能的变化

目的:探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患儿进行扁桃体腺样体切除术后机体免疫功能的变化。方法:检测OSAHS患儿扁桃体腺样体切除术前后血清免疫球蛋白IgG、IgA、IgM及CD3、CD4、CD8的水平,比较患儿术前和术后不同时期血清免疫球蛋白和T淋巴细胞亚群的变化。结果:患儿术后IgG、IgA、IgM及CD3、CD4、CD8的水平有所下降,但与术前相比差异无统计学意义。结论:OSAHS患儿进行扁桃体腺样体切除术对细胞免疫和体液免疫影响不大。儿童时期切除扁桃体和腺样体并不损害宿主免疫的完整性或减少宿主的免疫活力。     

程序性死亡受体1及其配体调控变应性鼻炎免疫偏移的实验研究

目的探讨程序性死亡受体1(PD-1)及其配体PD-L1、PD-L2在变应性鼻炎(AR)中的表达及其对AR免疫偏移的调控作用。方法收取2018年5月至2019年5月,因鼻腔高反应症状于武汉大学人民医院耳鼻咽喉头颈外科门诊就诊,或因鼻中隔偏曲住院行鼻中隔矫正手术的82例患者,男42例,女40例,年龄14~38岁。收集相应患者的临床资料、血液、下鼻甲黏膜标本。根据临床表现、皮肤点刺试验和血清特异性变应原筛查特异性IgE(sIgE)检测结果,将患者分为AR组和对照组。免疫组织化学法检测鼻黏膜中PD-1及配体的表达情况。流式细胞术检测外周血PD-1^+CD4^+T细胞、PD-L1^+髓样树突状细胞(mDCs)、PD-L2^+mDCs及Th2细胞比例。酶联免疫吸附(ELISA)法检测血清中总IgE、PD-1及配体分泌型(sPD-1、sPD-L1、sPD-L2)的表达水平。正态分布或经Ln转换后呈正态分布的计量资料组间比较采用t检验,相关性分析采用Spearman或Pearson相关,设P<0.05为差异有统计学意义。结果AR组鼻黏膜中免疫细胞表面PD-1及其配体的表达明显高于对照组。AR组外周血中PD-1^+CD4^+T细胞、PD-L1^+mDCs、Th2细胞比例明显高于对照组[(15.24±6.45)%比(8.71±5.33)%,(8.79±2.01)%比(5.74±2.90)%,(7.89±1.95)%比(2.52±1.34)%,P值均<0.05],两组PD-L2^+mDCs比例无明显差异。PD-1^+CD4^+T细胞比例与AR病情总体视觉模拟量表(VAS)评分、血清总IgE、sIgE浓度呈正相关(r值分别为0.501、0.541、0.608,P值均<0.05),PD-L1^+mDCs比例与AR病情总体VAS评分、sIgE浓度呈正相关(r值分别为0.604、0.563,P值均<0.05),Th2细胞比例与PD-L1^+mDCs、PD-1^+CD4^+T细胞比例呈正相关(r值分别为0.538、0.623,P值均<0.05)。AR组sPD-1、sPD-L1及总IgE表达水平较对照组明显升高[(4.40±1.01)pg/ml比(3.79±1.21)pg/ml、(3.88±0.25)pg/ml比(3.57±0.23)pg/ml、(6.34±1.38)ng/ml比(4.89±1.10)ng/ml,P值均<0.05],sPD-L2表达水平无明显差异。相关性分析发现sPD-L1与总IgE、sIgE浓度呈正相关(r值分别为0.32、0.45,P值均<0.05)。结论AR患者外周血及鼻黏膜组织中免疫细胞表面均高表达PD-1及PD-L1,AR患者外周血中sPD-1及sPD-L1表达水平升高,PD-1/PD-L1信号通路可通过诱导Th2型免疫反应促进AR炎性反应。     

Early stage impacts of tonsillectomy on immune functions of children

OBJECTIVE: The purpose of this study was to investigate the changes in the humoral and cellular immunity of patients with chronic tonsillitis before and 1 month after tonsillectomy. PATIENTS AND METHODS: 37 patients scheduled for tonsillectomy were enrolled in this study. The levels of CD3+, CD4+, CD8+, CD19+, CD25+ and CD16+ + 56+ were measured for cellular immunity, and levels of IgG, IgA, IgM, C3 and C4 were measured for humoral immunity in blood samples taken from these patients before and 1 month after the operation. RESULTS: The levels of CD3+, CD8+ and CD19+ were reduced in post-operative period as compared to pre-operative period but this was not statistically significant (P > 0.05). However it was found that the level of CD4+ was significantly increased while the level of CD25+ was reduced (P < 0.05) in the post-operative period. There were statistically significant differences between pre- and post-operative levels of immunoglobulins, C3 and C4, which were decreased after tonsillectomy (P < 0.05), but these levels were comparable with those of the control group. CONCLUSION: The results from the present study indicate that humoral and cellular immunity of patients undergoing tonsillectomy were decreased in the early period and came to normal later. The cellular and humoral immune responses are stimulated in patients with tonsillitis, and tonsillectomy removes this stimulus without negatively affecting the patient's immune functions.     

CD4+C25+Treg细胞与喉鳞状细胞癌的相关性研究

［摘要］目的：研究CD4+CD25+Treg细胞与喉鳞状细胞癌的相关关系。方法：收集2005年7月至2005年12月山东大学齐鲁医院耳鼻咽喉科手术治疗的30例喉鳞状细胞癌患者和同期13例健康献血者的外周血，应用流式细胞仪检测外周血中CD4+CD25+Treg细胞的百分比，用ELISA法检测外周血中TGF β，IL 10，IFN γ的含量。结果：喉鳞状细胞癌患者与正常对照组外周血中CD4+CD25+Treg细胞的百分比分别为（8.72±1.54）%和（4.64±0.93）%，喉鳞状细胞癌组高于正常对照组(P＜0.05)，但与性别、年龄、临床分期、淋巴结转移无关。喉鳞状细胞癌患者外周血中TGF β，IL 10含量分别为(10.96±1.19)?pg/ml和(15.87±2.17)?pg/ml，高于正常对照组的(6.77±0.72)?pg/ml,(1.8±2.5)?pg/ml (P＜0.05)；但IFN γ的含量为(16.67±8.39)?pg/ml，低于正常对照组的(21.98±9.64)?pg/ml(P＜0.05)。结论：CD4+CD25+Treg细胞在喉癌患者外周血中大量增加,下调T细胞介导的肿瘤免疫。