门静脉高压症脾脏淋巴细胞数量及增殖功能变化的研究  

Changes of number and function of lymphocytes in spleen of patients with portal hypertension

作　　者：吕高波[1] 张澍[1] 李宗芳[1] 黄莺[1] 张伟[1] 任松[1] 杨军[1] 党双锁[1] 

机构地区：[1]西安交通大学医学院第二附属医院干部病房普通外科,710004

出　　处：《中华肝胆外科杂志》2008年第11期770-773,共4页Chinese Journal of Hepatobiliary Surgery

基　　金：教育部新世纪优秀人才支持计划（2004）No：NCET-04-0932;陕西省科技攻关项目No：2004K14-G1（4）、2006K14-G2（4）

摘　　要：目的观察门静脉高压症（PH）脾脏内淋巴细胞数量及增殖功能的变化，为深入研究PH时脾脏免疫功能状态提供实验依据。方法选取12例PH脾亢病人的手术切除脾脏作为实验组，4例正常外伤性脾破裂病人的手术切除脾脏为对照组，称重后分离淋巴细胞，细胞计数板计数，计算淋巴细胞的相对数（每克脾脏组织中的淋巴细胞数）和绝对数（整个脾脏内淋巴细胞总数），采用免疫组化SP法观察脾脏内淋巴细胞密度和分布，MTT法观察淋巴细胞增殖功能的变化。结果与对照组相比，PH脾脏内淋巴细胞的密度降低，分布状况无明显区别；每克脾脏组织中的淋巴细胞（相对数）显著减少[（0．822±0．157）×10^8，对照组（1．174±0．254）×10^8，P〈0．01]，但由于重量较正常显著增加（832．64±278．2，对照组211．7±85．6，P〈0．01），淋巴细胞的总数（绝对数量）明显增多[（0．685±0．072）×10^11，对照组（0．366±0．057）×10^11，P〈0.01]，并且淋巴细胞的增殖功能增强，T细胞（0．022±0．005，对照组0．015±0．003，P〈0．05），B细胞（0．034±0．006，对照组0．023±0．001,P〈0．01）。结论PH脾脏内淋巴细胞密度和相对数量虽然减少，但其绝对数量增多，并且增殖功能增强。从这一角度考虑，PH脾脏可能仍具有免疫功能，但可能处于某种紊乱状态。对PH脾脏免疫功能的确切评价尚待进一步研究。Objective To investigate the changes of number and proliferative function of lymphocytes in patients with hypersplenism due to portal hypertension to provide the evidence about the change in the immunological function of hypertensive spleen. Methods Twelve spleens from the patients with PH hypersplenism were employed to serve as PH group, 4 spleens from the cases of traumatic spleen rupture were regarded as the control group. The density, total quantities and proliferation of lymphocytes were studied by SP staining. The isolation and counting of the lymphocytes were con ducted and MTT method was used. Results As compared with the control group, the splenic lymphocytes in PH group showed that （ Ⅰ ） there was no difference in distribution but significant decrease in density; （ Ⅱ ） the number of lymphocytes in spleen per gram （relative quantity） was decreased sig nificantly [（0. 822±0. 157）× 10^8 , control group： （1. 174±0. 254） × 10^8 , P〈0.01] ; （ Ⅲ ）with the significant increase in the weight of PH spleen（832.6±278.2,control group：211.7±85.6,P〈0.01）, the total quantity of lymphocytes was increased significantly [（0. 685 ± 0. 072） × 10^11 , control group： （0. 366±0. 057） × 10^11 , P〈0.01]; （Ⅳ）the proliferative function of lymphoeytes was enhanced, T lymphocytes：（0.022±0.005, control group：0.015±0.003, P〈0.05）, B lymphoeytes （0.034± 0.006, control group 0. 023±0. 001, P〈0.01）. Conclusion Although the density of lymphocytes de creases in the spleen due to portal hypertension, the total quantities of lymphocytes increases because of the mass increases greatly and the proliferative function enhances. As for the lymphocytes, the hy pertensive spleens maybe still have immunological function, which is perhaps in disorder. However, the complete evaluation about the immunological function of the PH spleen needs further study.

关 键 词：高压症门静脉 脾脏 淋巴细胞 免疫功能 

分 类 号：R686[医药卫生—骨科学]