脾切除对单核吞噬系统的影响  

Effect of Splenectomy on Reticuloendothelial Function in the Presence and Absence of Sepsis

作　　者：成军[1] 陈易人[1] 胡振雄[1] 李德春[1] 

机构地区：[1]苏州医学院附属第一医院普外科

出　　处：《中华创伤杂志》1994年第3期119-120,共2页Chinese Journal of Trauma

摘　　要：观察了Ｗｉｓｔａｒ大鼠脾切除后在伴有或不伴有脓毒症情况下，单核吞噬系统（ＭＰＳ）清除９９ｍＴｃ亚锡植酸钠功能以及血浆纤维连结蛋白（ＰＦｎ）和透明质酸（ＨＡ）的变化。结果表明脾切除后，尤其合并感染时，肝脏不能完全替代脾脏功能，出现肝Ｋｕｐｆｅｒ细胞吞噬能力减弱，血中除半衰期延长，肝脏器官和每克组织ｃ／ｍｉｎ值百分率减少；其变化与ＰＦｎ相对降低及ＨＡ急剧增加有关。首次提出ＨＡ增高参与了脾切除后ＭＰＳ、免疫功能受抑和脾切除后凶险感染的发生。We have investigated the effect of splenectomy on RES function by measurement of technetium 99m intravascular clearance (T/2) and of alterrations in hepatic uptake and pulmonary retention in the presence and absence of sepsis. To determine these, two groups rats underwent splenectomy ( n =6) or laparotomy only ( n =6) 4 weeks before a second operation, another two groups rats had either splenectomy ( n =6) or laparotomy only ( n =6) followed 4 weeks later by cecal ligation and puncture (CLP) (sepsis). The T/2 increased and phagocytic index (K) and hepatic uptake decreased, especially in 20 hours following CLP. In another set of experiments, PFn and HA concentrations were measured in splenectomy ( n =12) or laparotomy only ( n =12) groups and splenectomy with CLP ( n =12) or laparotomy with CLP ( n =12). There were a significant reduction in PFn and elevated concentrations in HA, particularly after 9 hours sepsis. We conclude that splenectomy may not only have deleterious effects in terms of the host defense system, but may also cause RES depression, especially in the presence of sepsis. There is an important role of HA in the pathophysiology of postsplenectomy sepsis possibly.

关 键 词：脾切除 透明质酸 MPS PFN 

分 类 号：R657.6[医药卫生—外科学]