扁桃摘出に関する臨床免疫学的研究

習慣性扁桃炎について

抄録

Humoral as well as cellular immunological functions were examined before and after tonsillectomy in 84 patients with recurrent tonsillitis. The patients were divided into 3 groups: Group A: under 8, Group B: 9-15, Group C: over 16 years.
Elevated IgG was observed in 29.8% of Group A, in whom IgG returned to normal after tonsillectomy. IgG was low in 25% of Group B before tonsillectomy, which remained still low one month after tonsillectomy. Higher incidence of low CH₅₀ was observed in elder patients suggesting that chronic pathological changes exist in tonsils of these age groups. The low CH₅₀ value tended to become normal after tonsillectomy. C_3c was reduced before tonsillectomy in 69% of Group A, 60% of Group B and 60% of Group C, respectively. C3c, however, remained unchanged after tonsillectomy. The subpopulation of the T lymphocyte and the rate of lymphocyte blastic transformations estimated by PHA-P or PWM were low before tonsillectomy and became normal after tonsillectomy in many patients of the 3 age groups. While the peripheral T lymphocytes decreased in number in elder patients, the number of the T lymphocytes in removed tonsils increased as the age of the patients advanced.
This study would suggest that decision has to be made carefully whether tonsillectomy is indicated in Group A and B depending upon the results of immunological investigations. It is also suggested that immunological laboratory tests such as immunoglobulins or CH₅₀ should be serially carried out after tonsillectomy.