充血性脾大伴脾功能亢进患者不同脾切除术前后血小板相关抗体的变化

CHANGES OF PLATELET ANTIBODY IgG LEVEL IN PATIENTS WITH CONGESTIVE SPLENOMEGALY AND HYPERSPLENISM AFTER DIFFERENT SPLENIC OPERATIONS

目的 了解充血性脾肿大伴脾功能亢进 (脾亢 )患者血小板相关抗体 (PA IgG)水平及不同脾切除术后的改变 ,探索脾肿大、血小板、PA IgG之间的关系。 方法 采用竞争性酶联免疫吸附试验 (ELISA)检测了 2 4例脾肿大伴脾亢患者血清PA IgG水平。 结果 脾肿大伴脾亢患者的PA IgG水平明显高于正常者 (P <0 .0 1) ,而血小板值低 ,PA IgG与血小板之间存在显著负相关 ( r=-0 .4747,P <0 .0 5 )。脾次全切除和脾切除术后 ,PA IgG水平下降 ,血小板上升 ,两者之间的负相关关系消失。结论 机体内可能存在PA IgG与血小板的免疫调节机理 。

Objective To defect the level of platelet antibody IgG (PA IgG) in patients with congestive splenomegaly and hypersplenism and the change of PA IgG level after splenectomy and subtotal splenectomy. Methods Twenty four cases of congestive splenomegaly and hypersplenism were investigated. Results The level of PA IgG in 24 cases were higher than normal range ( P <0.01), while the platelet count were lower than normal range and there was a significant negative correlation between the level of PA IgG and platelet count ( r =-0.4747, P <0.05). After subtotal splenectomy or splenectomy, the level of PA IgG descended, the platelet count raised and the negative correlation between the level of PA IgG and platelet count disappeared. Conclusion The results suggest that there is a immunoregulation between PA IgG and platelet. Perhaps spleen has some relation with the immunoregulation.