门静脉高压症脾功能亢进时脾脏巨噬细胞功能变化的研究

目的 观察门静脉高压症脾功能亢进时脾脏巨噬细胞(Mψ)的功能变化.方法 选取西安交通大学医学院第二附属医院2005年9月至2006年3月收治的门静脉高压症脾功能亢进患者12例,均为慢性乙型肝炎患者(实验组),同期外伤脾破裂患者4例(正常对照组).所有患者均行脾脏切除术.贴壁培养法分离纯化脾脏组织Mψ,RPMI-1640培养液将收获的细胞制备成细胞悬液,应用Vybant Phagocytosis Assay试剂盒、人TNF-α EliSpot试剂盒、DQTM ovalbumin试剂盒检测脾脏Mψ的吞噬、分泌及抗原呈递功能.结果 与正常脾脏Mψ相比,门静脉高压症脾功能亢进脾脏Mψ的吞噬率、抗原呈递阳性细胞比例和分泌TNF-α的阳性细胞数(每105个细胞中阳性分泌细胞数)明显增高(86.4±7.1比61.8±4.1,26.3±1.6比15.6±1.8,387.0±24.3比240.3±13.0,P<0.01).结论 门静脉高压症时脾脏Mψ吞噬、抗原呈递和分泌功能明显增强,细胞处于活化状态,进一步说明门静脉高压症时脾脏没有完全丧失免疫功能,但可能处于某种紊乱状态.

Changes in splenic macrophage function of hypersplenism due to portal hypertension

Objective To investigate the changes in function of splenic macrophages of hypersplenism due to portal hypertension (PH), and to providing experimental evidence for exploring the immune function of spleen in PH. Methods Twelve patients with hypersplenism due to PH and four patients with traumatic rupture of spleen, from September 2005 to March 2006, were enrolled into PH group and control group, respectively. Splenic Mψ were isolated and purified by anchoring cultivation from all the patients, and were resuspended by RPMI-1640. Phagncytosis, cytokine secretion and antigen processing and presenting of splenic Mψ were detected by Vybrant Pbegocytosis Assay, the human TNF-α Elispot kits and DQTM ovulbumin. Results Compare to the normal splenic Mψ, the phgocytosis rate, antigen presentation positive cells and secretion positive cells, were all significantly increased in PH splenic Mψ (86.4±7.1 vs.61.8±4.1,26.3±1.6 vs. 15.6±1.8,387.0±24.3 vs. 240.3±13.0, P<0.01). Conclusions The phagocytosis, cytokine secretion and antigen processing and presenting of splenic Mψ in PH spleen were all significantly increased, and the Mψ retained at activated state. It means that the PH spleen still possessed the immune function, but these functions might be in disorder. It still needs more research to get the precious evaluation for immune function in the PH spleen.