切脾对晚期血吸虫病病人的远期影响

目的 观察切脾后对病人的远期影响.方法 239例晚期血吸虫病人抽取周围静脉血检测WBC、RBC、PLT、EOS、ALT、ALP、A、TB、HA、LN、Ⅳ-C、PCⅢ、IGG、IGA、C3、C4、CD3、CD4、CD8、CD19.结果 切脾组WBC、PLT、EOS明显高于巨脾组,接近正常水平;切脾组ALT、ALP高于巨脾组,A、TB低于巨脾组;切脾组CD3、CD4较低,CD19较高;IGG、IGA较高,C3、C4较低;切脾组LN、Ⅳ-C高于巨脾组,HA、PCⅢ无明显差异.结论 切脾后不利于肝功能恢复;细胞免疫受损,体液免疫增强;有加速肝纤维化进程的可能.笔者认为对于晚期血吸虫病人选择切脾时,应更加慎重.

Long-term efficacy of splenectomcy for patients with advanced shistosomiasis japonica

Objective To study the long-term efficacy of splenectomy for patients with advanced shistosomiasis japonica.Methods Levels of WBC,RBC,PLT,EOS,ALT,ALP,GGT,A,TB,HA,LN,Ⅳ-C,PCⅢ,IGG,IGA,C3,C4,CD3,CD4,CD8,CD19 in periphetral venous blood were determined in 239 patients with advanced shistosomiasis.Meanwhile,the liver,gallbladder and spleen were examined with ultrasonography.Results The levels of WBC,PLT,EOS,ALT,ALP,IGG,IGA,LN,Ⅳ-C,CD19 increased in splenectomy group,the levels of A,TB,CD3,CD4,C3,C4 decreased in splenectomy group,while RBC,HA,PCⅢ,CD8 were not changed.Conclusion Splenectomy is a danger to hepatic function.Humoral immunity increases while cellular immunity decreases in splenectomy group.Splenectomy may aggravate the hepatic fibrosis in patients with advanced shistosomiasis.