手术治疗儿童腺样体肥大伴过敏性鼻炎的相关机制

The Mechanism of Surgical Treatment of Adenoid Hypertrophy with Allergic Rhinitis in Children

摘要: 腺样体是位于鼻咽部的外周淋巴组织，是咽淋巴环的一部分，参与人体免疫，而肥大的腺样体可以造成上呼吸道阻塞，引起患儿打鼾、张口呼吸等症状，严重时可造成患儿发育不良等。临床上治疗腺样体肥大(adenoid hypertrophy, AH)往往是通过药物及手术切除等方法。儿童过敏性鼻炎(allergic rhinitis, AR)近年来得到越来越多的关注，大大降低患儿生活质量。临床工作中发现AR与AH的发生存在联系，患儿在行腺样体切除手术后，过敏性鼻炎症状可以得到明显缓解。本文依据现有文献，从上呼吸道阻塞、鼻黏膜纤毛清除功能、局部变应性反应、微生物环境、免疫调控五个方面探讨产生该结果的机制。

Abstract: Adenoids are the peripheral lymphoid tissues located in the nasopharynx and are part of the phar-yngeal lymph ring. They are involved in the immune system, while enlarged adenoids can cause ob-struction of the upper respiratory tract, causing snoring and mouth-opening breathing in children, when serious may cause the child to be ill-developed and so on. Adenoid hypertrophy (AH) is usual-ly treated by drugs and surgery. Children’s allergic rhinitis (AR) has received increasing attention in recent years and it greatly reduces the quality of life of children. The association between AR and AH was found in clinical practice, and the allergic rhinitis symptoms were significantly relieved af-ter adenoidectomy. Based on the existing literature, the mechanism of this effect was discussed from five aspects: upper airway obstruction, nasal mucociliary clearance, local allergic reaction, mi-crobial environment and immune regulation.