脾脏在失血性休克状态下体液免疫中的作用及氧合液复苏对其的影响

目的　探讨脾脏在失血性伏克后的免疫调节作用。方法　取失血性休克犬进出脾脏的动静脉血及脾组织匀浆比浊法测定血浆及组织内IgA ,IgM ,IgG和补体C 3,C 4含量。 结果　失血性休克后 30min动脉血浆IgG有轻度降低 ,休克 2h后IgG ,IgM ,IgA水平均明显降低。从脾静脉取血测定结果休克后 30min各指标无显著变化 ,休克后 2h休克组IgG水平降低 ,IgM和IgA水平轻度增高。脾组织匀浆测定结果是休克后 2hIgG水平有明显增高 ,IgM和IgA水平有轻度降低 ,C 3和C 4水平增高。失血性休克经氧合液复苏后上述指标均有改善 ,IgG ,IgM水平增高 ,C 3,C 4水平降低。结论　脾脏在抗体及补体的生成与释放上有重要调节功能 ,失血性休克可以降低其功能 ,改变体液免疫状态 ;而及时给以氧合高渗高胶液治疗可改善脾脏功能 ,纠正机体的体液免疫失衡 ,从而有利于休克的复苏。

Function of Spleen in Humoral Immunity under HemorrhagicShock and Affect of Oxygenated Solution Resuscitation on It

Objective To investigate the immunoregulatory effect of spleen in hemorrhagic shock. Methods The content of immunoglobulin A, G, M and complement 3, 4 in arterial and veinal blood of spleen and in spleen tissue were determined by radioimmunoassay. Results 30 mins after hemorrhagic shock, the IgG level in arterial plasma was moderately reduced, two hours after hemorrhagic shock, the level of IgG, IgM and IgA was reduced significantly. In above various index there was no significant change 30 min after hemorrhagic shock, but twohours after shock the IgG level was reduced, the IgM and IgA level was moderately increased from spleen veinal sampling. The results of spleen tissue hemogenate determination showed that the IgG level was obvious increased, but the IgM and IgA level was moderately reduced, C 3 and C 4 level was increased two hours after hemorrhagic shock. After oxygenated solution resuscitation on hemorrhagic shock, above all indexes improved obviously, the IgG and IgM levels were increased, the C 3 and C 4 levels were reduced. Conclusion The spleen has significant regulatory function on the formation and release of antibody and complement, the hemorrhagic shock may reduce this function and change the condition of humoral immunity; but the treatment of oxygenated hypertonic hypercolloid solution in time may improve the spleen function, and correct the dysequilibrium of humoral immunity, and be hulpful for resuscitation of shock.