童年后扁桃体切除对人体免疫功能远期影响的研究

目的探讨童年后扁桃体切除对人体免疫功能的远期影响。方法采用配对对照法,对30例扁桃体切除术后5年以上(平均20.5年)、切除时年龄10岁以上(平均21.5岁)的病例和30例未行扁桃体切除的配对对照者进行术后病史问卷调查和相关免疫学指标检测。结果与对照组比较,观察组病例术后上感发生频率、免疫相关性疾病罹患率的组间差异无统计学意义,但上呼吸道慢性炎症罹患率为40%,显著高于对照组(6.7%,P<0.05);血清IgA水平和中性粒细胞比例虽然显著低于对照组(P<0.05),但观察组病例的绝对数值仍在正常范围内;其余各项相关指标组间差异均无统计学意义。结论童年后扁桃体切除可能会增加上呼吸道慢性炎性疾病(特别是慢性咽炎)的罹患率,甚至可能引起个别免疫学指标改变,但对人体一般健康状况和整体免疫功能无明显远期影响。

Study on long-term influence of tonsillectomy on immune functions

Objective To investigate the long-term effects of tonsillectomy on the immune functions and general health status of persons received this surgery after childhood.Methods Thirty patients received tonsil- lectomy at the age above 10 years old,with an averaged age of 21.5 year-old,and with a post-operative duration more than 5 years,with an averaged duration of 20.5 years,were included in this study,surveyed by question- naire method on their ill history following the operation and laboratory measurements on their immunity-related indicators by a paired program,and another 30 paired persons not undergone tonsillectomy were taken as the controls.Results When compared with that of controlling group,there were no significant differences seen ei- ther in the incidence of upper respiratory tract infection or in that of immunity-related conditions.However,the rate of chemic inflammatory lesions in the upper respiratory tract in observed cases was 40%,significantly high- er than that in controlling group(6.7%,P<0.05).While the number of neutrophilic granulocytes and the se- rum level of IgA in observed cases were significantly lower than that in controlling persons (P<0.05),their values were still in the normal range of limitation.Furthermore,there were no significant differences found in the other indicators,such as the number of white blood cells,mononuclear cells and lymphocytes and the levels of IgG,IgM,C3,C4,CD56,CD16,CD3,CD4,CD8 and CD19,between the two groups.Conclusions Althougl tonsillectomy undergoing after childhood may lead to an increased incidence of chronic inflammatory lesions in the upper respiratory tract,particularly in that of chronic pharyngitis,as well as the changes in the individual immune indicators,there will be no significant long-term pathological effects either on the general health status or on the whole immune function of the subjects.