脾栓术治疗脾功能亢进疗效观察及血清促吞噬肽水平变化的研究

Effect of partial splenic embolism on hypersplenism and research of serum tuftsin level

目的探讨部分脾栓塞术(partialsplenicembolism,PSE)治疗门静脉高压症并发脾功能亢进的疗效,并以促吞噬肽(Tuftsin)为代表,评价患者脾脏免疫功能变化。方法通过PSE治疗14例并发脾功能亢进的门脉高压症患者,比较PSE前后外周血象的缓解情况及Tuftsin的变化。结果14例门脉高压症患者术前的脾亢症状,经PSE后可观察到白细胞(WBC)和血小板(PLT)均明显上升,脾脏缩小,血清Tuftsin较术前无显著性变化而脾切除术后却明显降低。结论PSE可有效缓解门脉高压性脾功能亢进;PSE后Tuftsin水平较术前无显著下降,提示PSE不损害脾脏免疫功能;而脾切除术后Tuftsin水平较术前显著下降,提示脾脏免疫功能较术前降低;比较PSE和脾切除术,它们均可有效缓解脾亢,但是PSE不破坏脾脏免疫功能,而脾切除术后脾脏免疫功能下降。

[Objective]To investige the effects of partial splenic embolization (PSE) on hypersplenism as a complication of portal hypertension patients and evaluate the immunologic function changes of spleen by serum Tuftsin level. From Feb. 2000 to May. 2001, 24 portal hypertension patients with hypersplenism were investigated. We assaied the white blood cell (WBC), platelet (PLT) and serum Tuftsin at pre-PSE and post-PSE as well as at pre-splenectomy and post-splenectomy, then compared them. At post-PSE and post-splenectomy, WBC and PLT improved obviously (P<0.05). The levels of Serum Tuftsin decresed significantly at post-splenectomy while there were no changes at post-PSE. [Conclusion] PSE and splenectomy are both effective therapies to hypersplenism of portal hypertension patients; PSE can maintain immunologic function of spleen but splenectomy can′t.