脾栓塞对肝硬化患者外周血T淋巴细胞亚群的影响

目的 :研究部分脾栓塞治疗脾功能亢进对肝硬化患者T淋巴细胞亚群的影响。方法 :57例肝硬化并脾功能亢进患者 ,32例采用部分脾栓塞治疗 ,2 5例采用脾全切治疗 ,1 5例正常人作为对照 ,比较两组治疗前后外周血T淋巴细胞亚群的变化。结果 :肝硬化患者外周血T淋巴细胞 (CD3+ )、T辅助 /诱导淋巴细胞亚群 (CD4+ )、T辅助淋巴细胞 /T抑制淋巴细胞亚群 (CD4+ /CD8+ )明显低于正常人 (P <0 .0 1 ) ;脾栓塞组治疗前后CD3+ 、CD4+ 、CD8+ 、CD4+ /CD8+ 无明显差异 (P >0 .0 5) ;脾全切组治疗后CD3+ 、CD4+ 、CD4+ /CD8+ 均较治疗前及部分脾栓塞组治疗后明显降低 (P <0 .0 1 )。结论 :肝硬化患者外周血CD3+ 、CD4+ 、CD4+ /CD8+ 降低 ,部分脾栓塞治疗脾功能亢进 ,对肝硬化患者外周血T淋巴细胞亚群无明显影响 ,显著优于脾全切治疗

The Effect of Splenic Embolization on T Lymphocyte Subsets in Peripheral Blood in Patients with Cirrhosis of Liver

Purpose: To investigate the effect of partial splenic embolization (PSE) to treat hypersplenism on T lymphocyte subsets in peripheral blood in patients with cirrhosis of liver. Methods: In 57 cases of cirrhosis of liver associating with hypersplenism, 32 cases were treated with PSE, 25 cases were treated with total splenectomy. 15 cases of normal person acted as control group. The levels of T lymphocyte subsets in peripheral blood in the two groups were compared. Results: The levels of T lymphocyte(CD3 +), helper/inducer T lymphocyte (CD4 +) and helper T lymphocyte/suppressor T lymphocyte (CD4 +/CD8 +) obviously decreased in patients with cirrhosis of liver compared with those in normal person (P<0.01). There were no obvious difference in levels of CD3 +, CD4 + and CD4 +/CD8 + between pre-treatment patients and post-treatment patients in PSE group (P>0.05). The levels of CD3 +, CD4 + and CD4 +/CD8 + in post-treatment patients in total splenectomy group decreased compared with those in pre-treatment patients and those in post-treatment patients in PSE group (P<0.01). Conclusion: The levels of CD3 +, CD4 + and CD4 +/CD8 + in peripheral blood in patients with cirrhosis of liver decreased PSE to treat hypersplenism has not effect on T lymphocyte subsets in peripheral blood in patients with cirrhosis of liver. It is superior to total splenectomy.