部分脾栓塞术对肝硬化伴脾功能亢进患者门静脉压力、肝纤维化、炎症因子水平的影响  

Effect of Partial Splenic Embolization on Portal Vein Pressure, Liver Fibrosis and Inflammatory Factor Levels in Patients with Liver Cirrhosis and Hypersplenism

作　　者：姜海燕[1] 赵春红[1] 陈男男 陈志赫 刘铭珠 JIANG Haiyan;ZHAO Chunhong;CHEN Nannan;CHEN Zhihe;LIU Mingzhu(Jiamusi Central Hospital,Heilongjiang Province,Jiamusi 154002,China;不详)

机构地区：[1]黑龙江省佳木斯市中心医院,黑龙江佳木斯154002

出　　处：《中国医学创新》2022年第12期5-9,共5页Medical Innovation of China

摘　　要：目的:探讨部分脾栓塞术(PSE)对肝硬化伴脾功能亢进(脾亢)患者门静脉压力、肝纤维化、炎症因子水平的影响。方法:选取2017年2月-2020年2月佳木斯市中心医院收治的80例肝硬化伴脾亢患者,采用随机数字表法将其分为对照组和观察组,每组40例。对照组给予脾切除术治疗,观察组给予PSE治疗。比较两组外周血象[白细胞计数(WBC)、红细胞计数(RBC)、血小板计数(PLT)]、门静脉血流动力学指标、肝纤维化指标[透明质酸(HA)、Ⅲ型前胶原肽(PⅢP)、层黏蛋白(LN)及Ⅳ型胶原(Ⅳ-C)]、炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和白细胞介素-18(IL-18)]及术后并发症发生情况。结果:术后1个月,两组WBC、RBC、PLT水平均高于术前,且观察组均高于对照组,差异均有统计学意义(P<0.05)。术后1个月,两组门静脉内径、流速、血流量、压力均低于术前,且观察组均低于对照组,差异均有统计学意义(P<0.05)。术后1个月,两组HA、PⅢP、LN、Ⅳ-C水平均低于术前,且观察组均低于对照组,差异均有统计学意义(P<0.05)。术后1个月,两组TNF-α、IL-6、IL-18水平均低于术前,且观察组均低于对照组,差异均有统计学意义(P<0.05)。两组切口感染、发热、食管静脉曲张破裂出血、脾脓肿发生率比较,差异均无统计学意义(P>0.05)。观察组腹腔积液、腹痛、血栓形成发生率均低于对照组,差异均有统计学意义(P<0.05)。结论:PSE能够提升肝硬化伴脾亢患者外周血象,改善门静脉血流,降低门静脉压力,减缓肝纤维化进展,下调炎症因子水平。Objective:To investigate the effect of partial splenic embolization (PSE) on portal vein pressure,liver fibrosis,and inflammatory factor levels in patients with liver cirrhosis and hypersplenism.Method:A total of80 patients with liver cirrhosis and hypersplenism admitted to Jiamusi Central Hospital from February 2017 to February 2020 were selected,they were divided into control group and observation group according to random number table method,with 40 cases in each group.The control group was treated with splenectomy,and the observation group was treated with PSE.Peripheral blood images[white blood cell count (WBC),red blood cell count (RBC),platelet count (PLT)],portal venous hemodynamic indexes,liver fibrosis indexes[hyaluronic acid (HA),type Ⅲ procollagen peptide (PⅢP),laminin (LN) and type Ⅳ collagen (Ⅳ-C)],inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6 (IL-6) and interleukin-18 (IL-18)]and the incidence of postoperative complications were compared between two groups.Result:1 month after surgery,the WBC,RBC and PLT levels in both groups were higher than those before surgery,and those in the observation group were higher than those in the control group,the differences were statistically significant (P<0.05).1 month after surgery,the portal venous vein diameter,flow rate,blood flow and pressure in both groups were lower than those before treatment,and those in the observation group were lower than those in the control group,the differences were statistically significant (P<0.05).1 month after surgery,the levels of HA,PⅢP,LN,Ⅳ-C in both groups were lower than those before surgery,and those in the observation group were lower than those in the control group,the differences were statistically significant (P<0.05).1 month after surgery,the levels of TNF-α,IL-6 and IL-18 in both groups were lower than those before surgery,and those in the observation group were lower than those in the control group,the differences were statistically significant (P<0.05).There were no significant di

关 键 词：部分脾栓塞术 肝硬化 脾功能亢进 肝纤维化 门静脉压力 炎症因子 

分 类 号：R575.2[医药卫生—消化系统] R657.6[医药卫生—内科学]