脾切除术对地中海贫血儿童体液和细胞免疫功能的影响

The Impact of Splenectomy to Thalassemia Children's Humoral and Cell-mediated Immunity

目的探讨脾切除术对地中海贫血儿童体液和细胞免疫功能的影响。方法18例4～14岁地中海贫血脾切除患儿，于术前和术后1周测定HGB、IgG、IgA、IgM、CD3、CD4、CD8及CD4／CD8水平，术后3个月至6年进行随访，了解贫血改善情况及有无严重感染疾病发生。结果患儿术后血红蛋白均值较术前明显提高，IgG、IgA、IgM、CD3、CD4、CD8及CD4／CD8术后1周与术前比较差异无统计学意义（P〉0．05）。远期随访患儿均恢复较好，无严重感染疾病发生。结论4岁以上地中海贫血患儿脾切除术后贫血症状明显改善，近期和远期体液免疫和细胞免疫功能均无改变。

Objective To investigate the impact of splenectomy to thalassemia children＇s humoral and cell-mediated immunity. Methods 18 cases of thalassemia children （4 - 14 years old） who were treated by splenectomy,determined the preoperative and postoperative 1 week＇s average HGB,IgG,IgA,IgM,CD3,CD4,CD8 and CD4/CD8 level,and follow-up were done 3 months to 6 years to obserre the feedback of the anemia and whether happened the serious infectious diseases. Results The children＇s postoperative average hemoglobin significantly improved than preoperative one, and both preoperative and postoperative 1 week determinations of IgG, IgA, IgM, CD3, CD4, CD8 and CD4/CD8 were normal,the difference had no statistical significance （P 〉0. 05）. The long-term follow-up showed nearly all of the children recovered better and no serious infectious disease. Conclusion The symptoms of anemia obviously improved in more than 4 years old children with thalassemia after splenectomy,the recent and the long-term humoral immunity and cellular immunity function had not any significant changes.