肝硬化巨脾切除对免疫功能的影响

Changes in immunologic function after splenectomy in patients with cirrhosis and splenomegaly

目的 :探讨肝硬化巨脾切除对免疫功能的影响。方法 :对 2 6例肝硬化巨脾患者切脾术前、术后两周、术后半年、一年分别抽取周围静脉血测定 Ig G,Ig A,Ig M,C3,C4,TNF,s IL- 2 R,CD+ 3,CD+ 4 ,CD+ 8,CD+ 4 /CD+ 8,用 F检验作出显著性测定。结果 :Ig G,Ig A,Ig M,C3,C4,TNF,s IL - 2 R,CD+ 8切脾前后差异均无意义 (P>0 .0 5 ) ,CD+ 3,CD+ 4 ,CD+ 4 / CD+ 8切脾后升高 ,差异显著 (P>0 .0 5 )。结论 :肝硬化巨脾切除后对体液免疫和细胞免疫均无不良影响 ,因而治疗性脾切除是合理的。

Objective: To investigate the effects of splenectomy on immunologic function in patients with cirrhosis and splenomegaly.Methods: Various essay including IgG, IgA, IgM, C 3 ,C 4 ,TNF,sIL-2R, CD + 3 ,CD + 4 ,CD + 8 ,CD + 4 /CD + 8 of the peripheral venous blood in 26 cirrhotic patients preoperatively and 2 weeks postoperatively , Follow up examination were also done half a year and one year postoperatively.Results: The results were analyzed by F-test. Except for the significantly higher levels of CD + 3 ,CD + 4 , CD + 4 /CD + 8 after splenectomy than they were preoperatively (P<0.05), all other indices have no significant change (P>0.05).Conclusion: Splenectomy in patients with cirrhosis has no significant adverse effects on the humoral and cellular immunity, which justifies the resection of pathologic spleen.