门静脉高压症脾功能亢进时脾脏巨噬细胞功能变化的研究  

Changes in splenic macrophage function of hypersplenism due to portal hypertension

作　　者：李宗芳[1] 张澍[1] 

机构地区：[1]西安交通大学医学院第二附属医院外科,710004

出　　处：《中华外科杂志》2009年第2期89-91,共3页Chinese Journal of Surgery

基　　金：国家自然科学基金资助项目（30471672,30700795）;教育部新世纪优秀人才支持计划资助项目（NCET-04-0932）

摘　　要：目的观察门静脉高压症脾功能亢进时脾脏巨噬细胞（Mφ）的功能变化。方法选取西安交通大学医学院第二附属医院2005年9月至2006年3月收治的门静脉高压症脾功能亢进患者12例，均为慢性乙型肝炎患者（实验组），同期外伤脾破裂患者4例（正常对照组）。所有患者均行脾脏切除术。贴壁培养法分离纯化脾脏组织Mφ，RPMI-1640培养液将收获的细胞制备成细胞悬液，应用Vybant Phagocytosis Assay试剂盒、人TNF—α EliSpot试剂盒、DQ^TM ovalbumin试剂盒检测脾脏Mφ的吞噬、分泌及抗原呈递功能。结果与正常脾脏Mφ相比，门静脉高压症脾功能亢进脾脏Mφ的吞噬率、抗原呈递阳性细胞比例和分泌TNF—α的阳性细胞数（每10^5个细胞中阳性分泌细胞数）明显增高（86．4±7．1比61．8±4．1，26．3±1．6比15．6±1．8，387．0±24．3比240．3±13．0，P〈0．01）。结论门静脉高压症时脾脏Mφ吞噬、抗原呈递和分泌功能明显增强，细胞处于活化状态，进一步说明门静脉高压症时脾脏没有完全丧失免疫功能，但可能处于某种紊乱状态。Objective To investigate the changes in function of splenic macrophages of hypersplenism clue to portal hypertension （PH） , and to providing experimental evidence for exploring the immune function of spleen in PH. Methods Twelve patients with hypersplenism clue to PH and four patients with traumatic rupture of spleen, from September 2005 to March 2006, were enrolled into PH group and control group, respectively. Splenic Mφ were isolated and purified by anchoring cultivation from all the patients, and were resuspended by RPMI-1640. Phagocytosis, cytokine secretion and antigen processing and presenting of splenic Mφ were detected by Vybrant Phagocytosis Assay, the human TNF-α Elispot kits and DQTM ovalbumin. Results Compare to the normal splenic Mφ, the phgocytosis rate, antigen presentation positive cells and secretion positive cells, were all significantly increased in PH splenic Mφ （ 86.4 ± 7.1 vs. 61.8±4.1,26.3±1.6vs. 15.6±1.8,387.0±24.3vs. 240.3±13.0, P〈0.01）. Conclusions The phagocytosis, cytokine secretion and antigen processing and presenting of splenic Mφ in PH spleen were all significantly increased, and the Mφ retained at activated state. It means that the PH spleen still possessed the immune function, but these functions might be in disorder. It still needs more research to get the precious evaluation for immune function in the PH spleen.

关 键 词：高血压 门静脉 脾功能亢进 巨噬细胞 

分 类 号：R686[医药卫生—骨科学]