正常人,脾亢和脾破裂病人脾脏体视学研究

STEREOLOGICAL STUDIES ON SPLEENS OF NORMAL,CONGESTIVE SPLENOMEGALY AND TRAUMATIC RUPTURE

对13例正常人、34例脾功能亢进和11例脾破裂病人的脾脏进行了体视学研究,发现3组脾脏结构有明显的差异,脾亢组白髓体积密度和缘带体积密度均低于正常组;脾索和红髓内胶原纤维体积密度均高于正常组;脾破裂组白髓和胶原纤维体积密度均高于正常组;脾亢组病人脾脏体积和白髓体积密度呈负相关,脾索内胶原纤维体积密度和病程呈正相关,认为在行保脾手术时脾组织量的计算应以白髓为主。

In a series of 58 specimen of spleens,13 normal spleens,34 congestive splenomegalys and 11 traumatic rupture spleens were studied by stereology in this paper.Seven components of the spleens were mesured with stereological method and the stereological parameters were obtained. All individual comparisions of these parameters showed significant differences (P<0.005)and their correlation analyses demonstrated that no corre- lations exist except positive correlations between white pulp and mar- ginal zone in the normal and congestive splenomegaly(P<0.005).In the group of congestive splenomegaly,12 correlation analyses between stereological parameters and clinical data were carried out and the signif- icant correlations were found in white pulp volume fraction with splenic volume(r=-0.4981 0.005>P>0.0025),splenic cord volume fraction with the number of platelet(r=-0.6678,0.005>P>0.0025)and the col- lagen fiber volume fraction with the duration of the disease(r=0.5727, 0.001>P>>0.0005).In the comparisions of the stereological parameters among the three groups,the white pulp and the marginal zone volume fractions of the splenomegaly were less than those of the normal(P< 0.005),the volume fractions of the collagen fiber and the splenic cord in the splenomegaly were larger than those in the normal(P<0.005).In the splenic rupture group,the volume fractions of the white pulp and the splenic cord were larger than those in the normal,however,the volume fraction of the collagen fiber less than that in the normal(P<0.005). The remains showed no significant difference.This study provides a histo- logical basis for the autotransplantation of the spleen.It is the first time using stereological method to study the normal and the pathologic spleens and conclude that the spleen exists a significant individual disparity.In the congestive splenomegaly,the hyperplasia of the splenic components does not develop in proportion,the quantity of the white pulp decrease and the sinuses were not dilatation.