肝炎后肝硬化门静脉高压症脾内静脉血细胞计数与外周血细胞计数的比较

Intra-megalosplenic blood cell count and that in peripheral blood in patients of posthepatitic cirrhotic portal hypertension

目的研究乙型肝炎后肝硬化患者巨脾内静脉血细胞计数，并与外周血细胞计数进行比较，探讨肝炎后肝硬化门静脉高压症并发外周血细胞减少的原因。方法15例行脾切除术的乙型肝炎后肝硬化门静脉高压症患者，术中分别在脾上极、脾门（脾中极）和脾下极三段抽取脾内静脉血进行血细胞计数，并与术前的外周血细胞计数进行比较。结果脾内静脉血WBC计数与外周血WBC计数比较差异有统计学意义[（11．20±4．73）×109／L比（4．06±1．75）×10^9／L，t=5．05，P〈0．05]；脾内静脉血PLT计数与外周血PLT计数比较差异有统计学意义[（182．45±66．57）×10^9／L比（63．54±28．40）×10^6／L，t=7．285，P〈0．05]；脾内静脉血RBC计数与外周血RBC计数比较差异无统计学意义[（3．55±0．94）×10^12／L比（3．01±0．62）×10^12／L，t=1．874，P〉0．05]。脾下极静脉血PLT计数与脾门及脾上极比较差异均有统计学意义（均P〈0．01），而在脾上极、脾门、脾下极三处静脉血WBC计数和RBC计数比较差异均无统计学意义（均P〉0．05）。脾内静脉血PLT计数与外周血PLT计数存在正相关（r=0．610，P〈0．05）。结论乙型肝炎后肝硬化门静脉高压症患者巨脾内静脉血PLT和WBC计数均比外周血PLT和WBC计数显著增高：巨脾内静脉血PLT计数与外周血PLT计数存在正相关。

Objective To investigate the intra-splenic blood cell count of posthepatitic cirrhotic portal hypertension, and compare it with patients＇ peripheral blood cell count to explore the role the spleen plays in peripheral cytopenia often seen in posthepatitic cirrhotic portal hypertension. Methods A prospective study was made on 15 cases with post hepatitis B cirrhotic portal hypertension undergoing splenectomy. Intrasplenie blood was sampled from upper pole, hilus （ central pole） , and lower pole of the spleen respectively for blood cell count. Results were compared with that of preoperative peripheral blood. Results There were significant statistical differences in the WBC count between splenic blood and peripheral blood, （ 11.20±4. 73）×10^9/L vs. （4. 06 ± 1.75）× 10^9/L, t =5.05, P 〈0. 05）, and in PLT count, （ 182. 45 ± 66. 57 ） × 10^9/L vs. （ 63.54 ± 28.40） ×10^9/L, t = 7. 285, P 〈 0. 05. There was no differences in the RBC count, （3.55 ±0. 94）× 10^12/L vs. （3.01 ±0. 62） ×10^12/L, t = 1. 874, P 〉0. 05. Positive correlations were found between splenic PLT count and peripheral PLT count （ r = 0. 610, P 〈 0. 05 ）. Conclusions In posthepatitic B cirrhotic portal hypertension patients the intra-megalosplenic PLT and WBC count are significantly higher than that in peripheral blood. Megalosplenic PLT count correlates positively with peripheral PLT count.