门静脉高压症患者巨脾组织CD细胞的变化

目的研究门静脉高压症（PHT）脾功能亢进患者巨脾组织CD细胞的变化，探讨PHT患者的免疫功能特点。方法切除的巨脾组织制成石蜡切片，检测CD3^＋、CD8^＋、CD20^＋、CD68^＋阳性细胞数量及分布，与正常脾组织进行比较。结果（1）PHT巨脾与正常脾脏比较，CD3^＋、CD8^＋、CD20^＋、CD68^＋细胞数均减少。（2）正常脾脏的CD68^＋（Mφ）主要分布在脾小体和红髓（RP）；PHT脾脏CD68^＋主要分布在脾小体和动脉周围淋巴鞘（PALS）。PHT脾脏脾小体、红髓及边缘区（MZ）3个部位单位面积的CD68^＋数量较正常减少，以脾小体和红髓明显。结论PHT患者CD细胞数量及分布均有改变，脾切除术可能使其免疫功能得到一定恢复，并能纠正血常规及肝功能的异常。本研究所检测的免疫指标并不能完全说明患者全身的免疫状态，对门静脉高压症脾功能亢进患者的免疫状态应长期随访。

The changes of CD cells in splenic tissue in patients with portal hypertension

Objective To investigate the changes of CD cells in splenic tissue in patients with portal hypertension(PHT) accompanied by hypersplenism to explore the features of immunological function in patients with PHT.Methods The resected splenic tissue was made into paraffin sections for the detection of number and distribution of CD_3~+,CD_8~+,CD_(20)~+ and CD_(68)~+ cells,with the control of those in healthy individuals.Results The numbers of CD_3~+,CD_8~+,CD_(20)~+ and CD_(68)~+ cells remarkably decreased in patients with PHT accompanied by hypersplenism compared with those in normal controls.In normal controls,the CD_(68)~+ cells mainly existed in splenic lymphocyte nodules and red pulp(RP),and in patients with PHT,they existed in splenic lymphocyte nodules and periarterial lymphatic sheath(PALS).Compared with the normal controls,the numbers of CD_(68)~+ in splenic lymphocyte nodules,red pulp and marginal zone(MZ) decreased in patients with PHT.Conclusion The number and distribution of CD cells are changed in patients with PHT accompanied by hypersplenism.With splenectomy,the immunological function may be improved and the abnormalities in routine blood parameters and liver function be corrected.However,the immunological indexes detected in the study can not completely show the systematic immunological function of the patients with PHT accompanied by hypersplenism.Thus we should conduct a long-term follow-up study on immunological function in these patients.