大鼠门脉高压症脾次全切除术对部分免疫功能的影响  

The influence of subtotal splenectomy on partial immunlogi-cal function in rats with poroal hypertension

作　　者：李铁民[1] 刘程伟[2] 张雪松[3] 王树卿[3] 罗维[3] 张强[2] 

机构地区：[1]中国医科大学附属第一医院普外一科,辽宁沈阳110001 [2]中国医科大学附属第一医院普外三科,辽宁沈阳110001 [3]佳木斯大学附属第一医院普通外科,黑龙江佳木斯154003

出　　处：《中国现代普通外科进展》2006年第1期20-22,共3页Chinese Journal of Current Advances in General Surgery

基　　金：国家自然科学基金资助项目(C03030303)

摘　　要：目的:通过门脉高压症(PHT)脾次全切除术后细胞免疫和体液免疫的变化,初步评价脾次全切除术在门脉高压症中的作用。方法:建立肝硬化PHT大鼠疾病模型。实验分5组,每组10只。正常对照组(NCG),实验对照组(ECG),全脾切除组(TSG),保留正常睥脏50％的脾部分切除组(R50％、NSG), 保留正常脾脏大小的睥部分切除组(RNSG)。术后4周对各组进行血常规、免疫球蛋白、T淋巴细胞亚群的测定及病理学检查。结果:术后4周R50％NSG组与RNSG组与NCG组和ECG组血常规、免疫球蛋白和T淋巴细胞亚群水平差异无统计学意义。ECG光镜下见假小叶,再生的肝细胞结节肝细胞索排列紊乱等肝硬化表现脾包膜增厚,脾实质充血严重。脾内纤维严重增生。R50％NSG和RNSG光镜下见肝纤维化程度减轻,脾包膜变薄,脾实质轻度充血。结论:PHT残余脾脏具有一定的生理功能;保留部分脾脏的脾部分切除术在一定程度上能够维持机体的体液免疫和细胞免疫。Objectivs：To detect the change of cell immunity and body fluid immunity after subtotal splenectomy in protal hypertension of rat,and preliminarily evaluate the role of subtotal splenectomy in protal hypertension.Methods：We established the rat model of hepatic cirrhosis portal hypertension.Rats were divided to five groups;normal control group（NCG）;experimental control group（ECG）,total splenectomy group（TSG）,retain fifty percent size of normal spleen group（R50%NSG）,retain the same size of normal spleen group（RNSG）.Measured the Blood routine,lmmunoglobulin,T lymphocyte subgroup and stained with hematoxylin and eosin（HE）at 4 weeks after surgery.Results：There were not significant different between RNSG and NCG in Blood routine.Immunoglobulin,T lymphocyte subgroup at 4 weeks after operation.ECG could be seen by light microscope that the tissue of normal hepatlc lobule was destruceted,and appeared pseudo-lobule,Disarrangement of regenerated hepatic cell nodus and liver cell cord,fatty degeneration in hepatlc cell,thickening of spleen capsule and serious congestion of spleen parenchyma,atrophy of white pulp and shrinking of folllcle and germinal center R50%NSG and RNSG could be seen that hepatle fibrosis,spleen capsule thichening and congesltion of splenic perenchyma to a less extent.Conelusion：Remaining spleen of portal hypertension caused by hepatic cirrhosis has physiology functions.in some degree,splenectomy of retaining the same size of normal spleen could maintain body fluid lmmunity and cell immunity of organism.

关 键 词：脾次全切除术 门静脉高压症 门静脉 免疫功能 

分 类 号：R657.6[医药卫生—外科学] R657.34[医药卫生—临床医学]