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目的 观察门静脉高压症患者脾功能亢进(脾亢)时,脾脏巨噬细胞(MΦ)吞噬功能及其与外周血细胞计数变化的相关性。方法 肝硬化门静脉高压症脾亢患者20例(脾亢组),外伤性脾破裂患者6例(对照组)。术前检测患者外周血细胞计数,并收集其手术切除的脾脏,用玻片贴壁法分离培养脾脏MΦ,鸡红细胞吞噬法检测MΦ的吞噬功能。结果 脾脏MΦ吞噬率:脾亢组为(12 6±3 0)%,显著高于对照组(6 9±0 5)%,P<0 01;吞噬指数:脾亢组为0 146±0 035,显著高于对照组0 076±0 008,P<0 01。外周血白细胞计数与脾MΦ的吞噬率负相关(r=-0 472,P<0 05),与吞噬指数也呈负相关(r=-0 625,P<0 01);外周血血小板计数与脾MΦ吞噬率负相关(r=-0 485,P<0 05),与吞噬指数负相关(r=-0 523,P<0 05)。结论 门静脉高压症脾亢脾MΦ吞噬功能增强可能是引起脾亢发生及决定脾亢程度的重要因素。
Objective To observe the phagocytic function of splenic macrophage (MΦ) and its correlation with peripheral blood cell count in patients with hypersplenism (hypersplenism) in patients with portal hypertension. Methods 20 cases of liver cirrhosis and portal hypertension with hypersplenism (hypersplenism group), 6 cases of traumatic rupture of spleen (control group). Peripheral blood cell counts were detected preoperatively, and their surgically resected spleens were collected. MΦ phagocytosis was detected by phagocytosis of chicken spleens by slide attachment method. Results The phagocytic rate of MΦ in spleen was (12 6 ± 3 0)% in hypersplenism group, which was significantly higher than that in control group (6 9 ± 0 5)%, P <0.01; Phagocytosis index was 0 146 ± 0 035 , Significantly higher than the control group 0 076 ± 0 008, P <0 01. Peripheral blood leukocyte counts were negatively correlated with the phagocytic rate of splenic MΦ (r = -0 472, P <0.05), but also negatively correlated with the phagocytic index (r = -0 625, P <0.01) There was a negative correlation between the phagocytic rate of MΦ and the phagocytic index (r = -0485, P <0 05). Conclusions The enhancement of phagocytic function of splenic MΦ in patients with portal hypertension may be an important factor in the pathogenesis of hypersplenism and the degree of hypersplenism.