急重肝炎淋巴细胞脆性与肝脏功能损伤的关系研究

The relationship study between the changes of the frangible lymphocyte and the degree of destroyed liver function in fulminant viral hepatitis

目的 研究急重肝炎患者淋巴细胞脆性的变化，观察其与肝病程度、预后的关系。方法 选择临床确诊的急重肝炎患者32例，慢重肝炎患者66例、健康成年人46例、3～5岁健康儿童15例，采用淋巴细胞脆性实验检测淋巴细胞天然免疫反应的变化。淋巴细胞和抗原靶细胞在37℃下温育5-30min，高倍镜下观察淋巴细胞破碎的程度，与靶细胞接触的淋巴细胞膜完整无破坏者其脆性为阴性，与靶细胞接触的淋巴细胞中，30％以内被破坏者为轻度脆性、30％-60％被破坏为中度脆性、超过60％被破坏为重度脆性。结果 46例健康成人中，淋巴细胞脆性发生率为30．4％，其中9例呈轻度脆性（19．6％），3例中度脆性（6．5％）和2例重度脆性（4．3％）。66例慢重肝炎患者中，淋巴细胞轻度脆性14例（21.2％），中度脆性7例（10．6％），重度脆性4例（6．1％），与健康成人比较无显著差异。32例急重肝炎患者中，只有4例淋巴细胞为脆性阴性，淋巴细胞轻度脆性4例（12．5％），中度脆性9例（28．1％），重度脆性15例（46．9％）。4例淋巴细胞脆性阴性的急重肝炎患者有3例在住院1月后痊愈，疾病急性期与恢复期同一人群的淋巴细胞脆性无明显变化。结论 急重肝炎人群的淋巴细胞脆性显著高于慢重肝炎患者，肝病患者淋巴细胞脆性与病情及预后有关。淋巴细胞脆性可能是机体淋巴细胞天然应急免疫反应的表现。

Objective To study the changes and the significance of the frangible lymphocyte in patients with fulminant viral hepatitis and investigate the relationship between the degree of frangible lymphocyte and the severe of fulminant viral hepatitis. Methods 32 cases confirmed with fulminant viral hepatitis, 66 cases with chronic hepatitis have been studied. 15 cases children from 3 to 5 years old and 46 cases adults have been used with control groups. 100/A lymphocytes （1 ×10^6/ml） and 100/A tumor cells（1 × 10^5/ml） mixed with 100/11 selfserum at 37℃ for 5min to 30min The fragmental lymphocyte can defined as a frangible lymphocyte. The lymphocyte attached with tumor cell is undestroyed anything can be regarded as negative frangible lymphocyte Less than 30 percent of lymphocyte attached with tumor ceils is destroyed will be conformed as low-grade frangible lymphocyte, between 30 percent to 60 percent regard as mid-grade, and more than 60 percent as severe-grade mode.Results The equiform frangible lymphocyte is detected in fulminant viral hepatitis and other groups like that in SAILS in 2003 years. There is none of children have frangible lymphocyte Only 3 person＇s lymphocytes show severe-grade frangible and 9 people display mid-grade in 46 adult individuals. Contrarily There is high of 46. 9 percent of cases with fulminant viral hepa- titis show severe-grade frangible lymphocytes, only 4 cases is negative and 3 cases is recovered in one months of them. The frangible lymphocytes in fulminant viral hepatitis are significantly lower than those in chronic hepatitis patients not only in mid-grade frangible but in severe type. There is no significant recovery of frangible lymphocyte from acute to recover in fulminant viral hepatitis, but the degree of the lymphocytes are closely relate to the state of an illness. Conclusion The percent of frangible lymphocytes in children is lowest among adult people, chronic hepatitis and fulminant viral hepatitis. The proportion of frangible lymphocytes in fulminant viral hepatitis is highest, and significantly higher than that in chronic hepatitis. The phenomenon of frangible lymphocytes may be an important characteristic of an innate immunology reaction of the body.