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1、·480-2o14年6月第l3卷第6期ChinjDigSurg,June2014,V01.13,No.6·論著·乙型病毒性肝炎肝硬化門靜脈高壓癥患者脾切除后CD4+CD25+CD127k一調(diào)節(jié)T細(xì)胞的變化及意義曾強(qiáng)苑曉燁楊圣俊王洋任貴軍高慶軍竇劍【摘要】目的觀察乙型病毒性肝炎肝硬化門靜脈高壓癥患者行脾切除術(shù)前后外周血中CD4CD25CD127調(diào)節(jié)性T細(xì)胞(Treg)的變化,探討門靜脈高壓癥患者行脾切除術(shù)對(duì)機(jī)體免疫功能的影響。方法回顧性分析2012年5月至2013年5月河北醫(yī)科大學(xué)第三醫(yī)院收治的2o例乙型病毒性肝炎肝硬化門靜脈高壓癥合并脾功能亢
2、進(jìn)患者的臨床資料,通過流式細(xì)胞儀分析乙型病毒性肝炎肝硬化門靜脈高壓癥合并脾功能亢進(jìn)患者(門靜脈高壓癥組)脾切除術(shù)前1d、術(shù)后1周、1個(gè)月、3個(gè)月和來自河北醫(yī)科大學(xué)第三醫(yī)院的1O例健康體檢者(對(duì)照組)的外周血中CD4CD25CD127一Treg含量,分析Treg的變化對(duì)全身免疫系統(tǒng)造成的影響。組問比較采用t檢驗(yàn),手術(shù)前后數(shù)據(jù)比較采用重復(fù)測(cè)量方差分析。結(jié)果門靜脈高壓癥組患者術(shù)前和對(duì)照組受試者CD4CD25CD127一Treg比例分別為5.1%±3.5%和1.4%±0.2%,兩組比較,差異有統(tǒng)計(jì)學(xué)意義(t=2.573,P<0.05)。門靜脈高壓癥組
3、患者術(shù)后1周、1個(gè)月、3個(gè)月CD4CD25CD127一Treg比例分別為9.2%4-2.7%、5.6%±1,7%、2.5%±2.1%,其中術(shù)后l周與術(shù)前比較,差異有統(tǒng)計(jì)學(xué)意義(F=9.814,P<0.05);而術(shù)后3個(gè)月與術(shù)前比較,差異無統(tǒng)計(jì)學(xué)意義(F=2.364,P>0.05)。結(jié)論脾切除術(shù)后短期Treg水平明顯升高,隨時(shí)間延長逐漸下降。從Treg方面表明脾切除對(duì)機(jī)體免疫系統(tǒng)影響較小?!娟P(guān)鍵詞】門靜脈高壓癥;脾切除;調(diào)節(jié)性T細(xì)胞ChangesandsignificanceofCIMCD25CD127一regulatoryTcellsinpa
4、tientswithportalhypertensionandhepatitisBvirusinfectionaftersplenectomyZeQiang,YuanXiaoye,YangShengjun,WangYang,RenGu咖n,GaoQingjun,DouJian.DepartmentofHepatobiliarySurgery,船Hospital,HebeiMedicalUniversity.shiiazhuango5oo51.ChinaCorrespondingauthor:DouJian,Email:278344@qq.co
5、rn【Abstract】0bjecfiveTodetectthechangesofcD4CD25CD127一regulatoryT(Treg)cellsinperipheralbloodinpatientswithDortalhypertensionandhepatitisBvirusinfectionbeforeandafterspleneetomy,andtostudytheeffectsofspleneetomyontheimmunefunctionofpatientswithportalhypertension.MethodsThec
6、linicaldataof20patientswithporta1hypertension.hepatitisBvirusinfectionandhypersplenismwhowereadmittedtotheThirdHospitalofHebeiMedica1UniversityfromMay2012toMay2013wereretrospectivelyana—lyzed.ThedynamiclevelsofCD4CD25CD127Tregcellsintheperipheralbloodofthe20patients(portalh
7、ypertensiongroup1atldaybeforesplenectomyandatpostoperativeweek1.month1andmonth3weredetectedbvflowcytometr~.a(chǎn)ndthedynamiclevelsofCD4CD25CDl27?Tregceilsintheperipheralbloodof10healthyindividuals(controlgroup)fromthesamehospitalwerealsodetectedbyfloweytometry.Theeffectsofchang
8、esofTregcellsontheimmunefunctionwereanalyzed.A11datawereanalyzedusingthettestorrep