摘要目的 观察门静脉高压症(PH)脾脏内淋巴细胞数量及增殖功能的变化,为深入研究PH时脾脏免疫功能状态提供实验依据.方法 选取12例P脾亢病人的手术切除脾脏作为实验组,4例正常外伤性脾破裂病人的手术切除脾脏为对照组,称重后分离淋巴细胞,细胞计数板计数,计算淋巴细胞的相对数(每克脾脏组织中的淋巴细胞数)和绝对数(整个脾脏内淋巴细胞总数),采用免疫组化SP法观察脾脏内淋巴细胞密度和分布,MTT法观察淋巴细胞增殖功能的变化.结果 与对照组相比,PH脾脏内淋巴细胞的密度降低,分布状况兀明显区别;每克脾脏组织中的淋巴细胞(相对数)显著减少[(0.822±0.157) × 108,对照组(1.174±0.254)×108,P＜0.01],但由于重量较正常显著增加(832.6±278.2,对照组211.7±85.6,P＜0.01),淋巴细胞的总数(绝对数量)明显增多[(0.685±0.072)×1011,对照组(0.366±0.057)×1011,P＜0.01],并且淋巴细胞的增殖功能增强,T细胞(0.022±0.005,对照组0.015 ±0.003,P＜0.05),B细胞(0.034±0.006,对照组0.023±0.001,P＜0.01).结论 PH脾脏内淋巴细胞密度和相对数量虽然减少,但其绝对数量增多,并且增殖功能增强.从这一角度考虑,PH脾脏可能仍具有免疫功能,但可能处于某种紊乱状态.对PH脾脏免疫功能的确切评价尚待进一步研究.

abstractsObjective To investigate the changes of number and proliferative function of lymphocytes in patients with hypersplenism due to portal hypertension to provide the evidence about the change in the immunological function of hypertensive spleen.Methods Twelve spleens from the patients with PH hypersplenism were employed to serve as PH group,4 spleens from the cases of traumatic spleen rupture were regarded as the control group.The density,total quantities and prolifcration of lymphocytes were studied by SP staining.The isolation and counting of the lymphocytes were conducted and MTT method was used.Results As compared with the control group,the splenic lymphocytes in PH group showed that ( Ⅰ ) there was no difference in distribution but significant decrease in density; ( Ⅱ ) the number of lymphocytes in spleen per gram (relative quantity) was decreased significantly [(0.822±0.157)× 108 ,control group: (1.174±0.254)×108 ,P＜0.01]; ( Ⅲ )with the significant increase in the weight of PH spleen(832.6±278.2,control group:211.7±85.6,P＜0.01),the total quantity of lymphocytes was increased significantly [(0.685±0.072) × 1011 ,control group:(0.366±0.057)× 1011,P＜0.01]; (Ⅳ)the proliferative function of lymphocytes was enhanced,T lymphocytes: (0.022±0.005,control group: 0.015± 0.003,P＜ 0.05 ),B lymphocytes ( 0.034 ±0.006,control group 0.023±0.001,P＜0.01).Conclusion Although the density of lymphocytes decreases in the spleen due to portal hypertension,the total quantities of lymphocytes increases because of the mass increases greatly and the proliferative function enhances.As for the lymphocytes,the hypertensive spleens maybe still have immunological function,which is perhaps in disorder.However,the complete evaluation about the immunological function of the PH spleen needs further study.