大部脾栓塞术对重型地中海贫血患儿免疫功能影响的研究

Immunologic function of children with severe mediterranean anemia after partial splenic embolization

目的评估大部脾栓塞术后重型地中海贫血患儿免疫功能的变化。方法对６２例患儿行脾大部栓塞术。结果ＩｇＧ在术后１周（１３±４ｇ／Ｌ）和术前（１６±６ｇ／Ｌ）差异有显著意义（Ｐ＜０．０５），术后３周恢复术前水平（１６±５ｇ／Ｌ）。ＩｇＡ、ＩｇＭ术前及术后各周均无明显差异。Ｔ细胞亚群中总Ｔ细胞数术前（４９±１２）和术后（６０±１２）差异有非常显著意义（Ｐ＜０．０１）。Ｔ辅助淋巴细胞（ＴＨ）术前（３８±９）与术后（４５±７）比较差异有非常显著意义（Ｐ＜０．０１）。ＴＨ／ＴＳ比值术后（１．６±０．３）与术前（１．２９±０．４）比较差异有非常显著意义（Ｐ＜０．０１），而Ｔ抑制淋巴细胞（Ｔｓ）术后（２９±７）与术前（３１±６）比较差异无显著意义（Ｐ＞０．０５）。纤维连接蛋白术后（２４８±７８）与术前（１１８±４１）比较差异有显著意义（Ｐ＜０．０５）。

Objective The purpose of this study was to assess the effect of partial splenic embolization (PSE) on immunologic function of patients with severe mediterranean anemia (SMA). Methods immunoglobulins were determined in 62 children with SMA before and after PSE. Also, lymphocyte subpopulation, lysozyme and fibronectin were measured in 40 cases. Results IgG was significantly lower one week after operation (12 8±4 3 g/L) than that before operation (16 2±5 5 g/L) ( P <0.05). It recovered three weeks after operation (15 8±5 1 g/L). Fibronectin was significantly higher after PSE (248±78 g/L) than that before PSE (118±41 g/L), but IgA, IgM and lysozyme levels remained unchanged during PSE. Total T, T helper lymphocytes (T H) and T H/T S ratio increased after PSE as compared with those before PSE ( P <0.01). Whereas, T suppressor lymphocytes (Ts) level remained unchanged during operation.Conclusion Immunologic function of children with SMA increased 3 weeks after PSE.