肝硬化脾大部分栓塞对T细胞亚群及sIL—2R水平影响及临床意义

目的：探讨脾大部分栓塞治疗对肝硬化肝功能失代偿期患者免疫功能影响。方法：检测肝硬化肝功能失代偿期患者脾大部分栓塞治疗前后，外周血T细胞亚群百分率及血清可溶性白细胞介素2受体水平变化，并与健康人对照，结果：肝硬化患者脾大部分栓塞前外周血CD3^ ,CD4^ 百分率，CD4^ /CD8^ 细胞比值均明显低于健康人，差异有统计学意义；栓塞治疗8周后，均有不同程度上升，但仍低于健康人（P＜0．05），而CD8^ 细胞百分率，血清可溶性白细胞介素2受体水平在栓塞前均显著高于健康人（前者P＜0．05，后者P＜0．01），栓塞后两者均下降，与健康人相比，前者P＞0．05，后者P＜0．05，结论:巨脾可能是肝硬化功能失代偿期患者免疫功能异常的重要原因之一，脾大部分栓塞可部分改善患者的免疫功能，有重大临床意义。

Clinical Significance of Changes in T Lymphocyte Subsets and Soluble Interleukin-2 Reception Levels in Cirrhosis with Spleen Arterial Embolization

Objective:To explore the changes and its clinical significance of immunologic function in cirrhosis patients with portal hypertension treated by spleen arterial embolization therapy.Methods:The proportion of T lymphocyte subsets were assayed by indirect immunofluorescence,and ELISA was used to measure the levels of soluble interleukin-2 reception.A comparative analysis was carried out between the patients before or after therapy and the control group.Results:The proportion of CD3 ,CD4 T cell and the ratio of CD4 /CD8 in peripheral bloods were significantly lower in patients before the treatment than those in cotrol group (P<0.01).Eight weeks later after spleen arterial embolization,they all went up to different degree,but sitll were lower than those in control group.The proportion of CD8 T cell and the concentration of soluble interleukin-2 receptions in serum were higher in patients before therapy than those in control group (P<0.05),and they were decreased remarkably after the treatment.Compared with that in control group,the difference in the proportion of CD8 T cell was not statistically significant (P>0.05).Conclusions:Huge spleen may be one of the important causes of immunologic function abnormality in cirrhosis with portal hypertension, and spleen arterial embolization can ameliorate partly patients' immunologic function.