肝炎肝硬化腹水患者输新鲜冰冻血浆前后免疫功能的变化及意义

Changes and significance of immune function in hepatitis patients with liver cirrhosis and ascites before and after fresh frozen plasma transfusion

目的:研究肝炎肝硬化腹水患者输新鲜冰冻血浆前后免疫功能的变化及意义。方法:86例肝炎肝硬化腹水患者随机分为一般治疗组及输血浆组,治疗前后测定患者的血IgGI、gMI、gA及补体C3,C4水平,并应用流式细胞仪测定外周血的T细胞亚群。结果:肝炎后肝硬化腹水患者治疗前血IgGI、gAI、gM明显高于正常,补体C3、C4明显低于正常。治疗后血IgGI、gAI、gM明显下降、补体C3、C4明显升高,治疗后两组比较,输血浆组血IgGI、gAI、gM水平轻微高于一般治疗组,无统计学差异;但血补体C3、C4水平高于一般治疗组,有显著统计学差异(P<0.05)。肝炎后肝硬化腹水患者治疗前外周血CD3、CD4及CD4/CD8比值较正常对照明显下降,CD8明显升高。两组治疗后CD3、CD4及CD4/CD8比值明显升高,CD8明显下降,较治疗前有显著统计学差异(P<0.05)。治疗后两组比较,输血浆组血CD3、CD4及CD4/CD8比值显著高于一般治疗组,CD8低于一般治疗组,有显著统计学差异(P<0.05)。结论:输注新鲜冰冻血浆能提高肝炎肝硬化腹水患者的细胞免疫及体液免疫功能。

Objective： To investigate the immune function changes and its significance in hepatitis patients with liver cirrhosis and ascites before and after fresh frozen plasma transfusion.Methods： 86 hepatitis patients with liver cirrhosis and ascites were randomly divided into general treatment group and fresh frozen plasma transfusion group.Serum IgG,IgM,IgA and complement C3,C4 level were detected and T cell subsets in peripheral blood were detected by flow cytometry in both group before and after treatment.Results： The Serum IgG,IgM,IgA level were signifcantly increased and complement C3,C4 level were signifcantly decreased in hepatitis patients with liver cirrhosis and ascites compared with control subjects.After treatment,The Serum IgG,IgM,IgA level were signifcantly decreased and complement C3,C4 level were signifcantly increased in general treatment group and fresh frozen plasma transfusion group.There was no statistical difference of Serum IgG,IgM,IgA level after treatment between both groups.But the complement C3,C4 level after treatment in plasma transfusion group were higher than those in general treatment group.Peripheral blood CD3,CD4 and CD4/CD8 ratio were also signifcantly decreased and CD8 was signifcantly increased in hepatitis patients with liver cirrhosis and ascites.After treatment,The CD3,CD4 and CD4/CD8 ratio were signifcantly increased and CD8 was signifcantly decreased in general treatment group and fresh frozen plasma transfusion group.The CD3,CD4 and CD4/CD8 ratio after treatment in plasma transfusion group were significantly higher than those in general treatment group.Conclusion： Fresh frozen plasma transfusion can improve the cellular and humoral immune function in hepatitis patients with liver cirrhosis and ascites.