脾脏切除对门脉高压症病人NK细胞活性的影响

门脉高压症瘀血肿大的脾脏是否具有免疫功能尚存有分歧。本文通过对保留脾脏的远端脾肾静脉分流手术病人和切除脾脏的门奇静脉断流手术病人的外周血NK细胞活性的测定,对照分析了脾切除对门脉高压症病人NK细胞活性的影响。结果表明:门脉高压症病人NK细胞活性显著低于正常人;脾切除后NK细胞活性呈渐进性升高,而保留脾脏的病人NK细胞活性无明显变化,术后两周脾切组显著高于保脾组(P<0.01)。提示门脉高压症病人瘀血肿大的脾脏对机体非特异性免疫功能有抑制作用,睥切除术后早期可改善门脉高压症病人的NK细胞活性。其远期效果有待随访。

The Effect of Splenectomy on Natural Killer Cell Artivity in Patients with Portal Hypertension

The effect of splenectomy on natural killer (NK) activity was examined in 40 patients with portal hypertension. The patients were divided into different groups based on two operative procedures: group of splenectomy and devascularization (n=23)and group of distal splen-renal shunt (DSRS) (preserving the spleen) (n=17). The results showed that the NK activity in patients with p(?) hypertension decreased more significantly than in normal subjects and increased progressively after splenectomy. In the group of DSRS, however, there were no significant changes in the postoperative period. On the 14th postoperative day there was a significant difference between the two groups (P<0.01). This finding suggests that congestive splenomegaly might have an inhibitory effect on non-specific immunity and splenectomy could enhance the NK activity of patients with portal hypertension in the earlier postoperative stage.