脾大脾脏巨噬细胞在门脉高压症脾亢发生中的作用

The role of splenomegaly and splenic macrophage in the occurrence of hypersplenism of portal hypertension

目的 探讨脾大、脾脏巨噬细胞 (MΦ)在门脉高压症 (PHT)脾亢发生中的作用。方法 采用免疫组化和透射电镜等方法 ,对比观察PHT脾脏MΦ 内ACP含量 ,MΦ 超微结构及MΦ 吞噬破坏血细胞数量的变化。并对PHT患者的脾指数、MΦ 内ACP含量及外周血细胞计数三者之间作相关分析。结果 同正常脾脏相比 ,PHT脾脏MΦ 内ACP含量增多 ,MΦ 表面伪足增多、增长 ,胞内溶酶体数量增多 ,MΦ 吞噬破坏红细胞、血小板的数量明显增多。PHT患者的脾指数和MΦ 内ACP含量与外周血细胞计数成反比 ,脾指数和MΦ 内ACP含量成正比。结论 脾大、脾脏MΦ 在PHT脾亢的发生中起着重要作用。

Objective To investigate the role of splenomegaly and splenic macrophage(M Φ)in the occurrence of the hypersplenism of portal hypertension(PHT). Methods The changes of the quantity of ACP in M Φ,the ulstrastructure of M Φ and the quantity of the blood cells phagocytized and destructed by M Φ in the spleen of PHT by the methods of immunohistochemistry and transmission electron microscope were observed and compared with the normal spleen.The correlation of spleen index,the quantity of ACP in M Φ and the peripheral blood cells counts were also studied.Results Comparing with the normal spleen,the quantity of ACP in M Φ was increased,the surface folopodia of M Φ was increased and lengthened and the quantity of lysosome in M Φ and the quantity of erythrocytes and platelets phagocytized by M Φ were increased.Spleen index and the quantity of ACP in M Φ were negatively correlated with the peripheral blood cells counts,spleen index was positively correlated with the quantity of ACP in M Φ.Conclusion The splenomegaly and splenic M Φ could play a vital role on the occurrence of the hypersplenism of PHT.