脾切除对乙肝肝硬化性门静脉高压合并脾功能亢进患者免疫功能、肝功能以及血常规的影响  

Effect of splenectomy on immunologic function,liver function and complete blood count in patients with hepatitis B cirrhosis-related portal hypertension complicated with hypersplenism

作　　者：杨宏志[1] 张涌泉[1] 许景洪[1] 侯海玲[1] 黄文文[1] 丛风云[1] 农文伟[1] 

机构地区：[1]广西医科大学附属民族医院肝胆胃肠外科,南宁市530021

出　　处：《广西医学》2015年第11期1591-1594,共4页Guangxi Medical Journal

摘　　要：目的探讨脾切除对乙肝肝硬化性门静脉高压合并脾功能亢进患者肝功能、血常规及免疫功能的影响。方法选择40例乙肝肝硬化性门脉高压合并脾功能亢进患者作为脾亢组,10例正常体检者作为对照组,检测脾亢组脾切除术前、术后第3、7天及对照组血常规、肝功能以及免疫功能。结果脾亢组术前免疫功能指标[(CD3^+、CD3^+CD4^+、CD3^+CD8^+、CD3-CD16^+CD56^+、CD19^+、免疫球蛋白(Ig)G、IgM、补体C3、C反应蛋白)]、ALB、WBC、PLT水平均低于对照组,凝血酶原时间(PT)长于对照组(P<0.05);脾亢组患者的CD3^+、CD3^+CD4^+、CD3^+CD8^+、IgG、IgM、补体C4、ALB、Hb、WBC及PLT随观察时间延长而升高,PT随时间延长而缩短(P<0.05)。结论乙肝肝硬化性门脉高压合并脾功能亢进患者肝功能、血常规均出现异常,免疫功能受到抑制;切除脾脏可改善患者肝功能、血常规和免疫功能指标。Objective To explore the effect of splenectomy on immunologic function,liver function and complete blood count in patients with hepatitis B cirrhosis-related portal hypertension complicated with hypersplenism. Methods A total of 40 patients with hepatitis B cirrhosis-related portal hypertension complicated with hypersplenism were enrolled as hypersplenism group,and 10 healthy persons as control group. The tests of complete blood count,liver function and immunologic function were conducted in the hypersplenism group before,three and seven days after splenectomy,and the tests were performed in the control group as well. Results Compared to those in the control group,the indices of immunologic function（ CD3~＋,CD3~＋CD4~＋,CD3~＋CD8~＋,CD3-CD16~＋CD56~＋,CD19~＋,IgG,IgM,C3 and C-reactive protein）,ALB,WBC and PLT levels were lower and prothrombin time（ PT） was longer in the hypersplenism group（ P 〈 0. 05）. In the hypersplenism group,the levels of CD3~＋,CD3~＋CD4~＋,CD3~＋CD8~＋,IgG,IgM,C4,ALB,Hb,WBC and PLT increased and PT decreased with the increasing observation time（ P 〈 0. 05）. Conclusion The liver function and complete blood count are abnormal,and immunologic function is depressed in patients with hepatitis B cirrhosis-related portal hypertension complicated with hypersplenism. Splenectomy can improve the patients’ liver function,complete blood count and immunologic function.

关 键 词：门静脉高压 肝硬化 乙型肝炎 脾功能亢进 脾切除 免疫功能 肝功能 血常规 

分 类 号：R657.34[医药卫生—外科学]