脾切除对门静脉高压症患者外周血中Th17细胞及免疫功能的影响

刘朝辉; 陈一杰; 张诚华

doi:10.3969/j.issn.1001-5256.2014.09.012

脾切除对门静脉高压症患者外周血中Th17细胞及免疫功能的影响

DOI: 10.3969/j.issn.1001-5256.2014.09.012

中国人民解放军第一八〇医院普外科

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中图分类号: R657.34
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出版历程
- 收稿日期: 2014-07-29
- 出版日期: 2014-09-20

Effects of splenectomy on peripheral blood Th17 cells and immune function in patients with portal hypertension

Department of General Surgery, No. 180 Hospital of PLA

摘要

摘要:
目的观察门静脉高压症患者行脾切除术前后外周血中Th17等免疫细胞的变化,分析脾切除于对门静脉高压症患者免疫功能的影响。方法选取中国人民解放军第一八〇医院2012年6月至2014年6月收治的采取脾切除术治疗的门静脉高压症患者25例作为观察组,同期25例健康体检者作为对照组。采用流式细胞术检测患者术前1 d、术后7 d、1个月、3个月,以及健康体检者外周血中T淋巴细胞亚群CD3、CD4、CD8、CD4/CD8及Th17细胞比率,ELISA检测患者血清中白细胞介素（IL）6、IL-17、IL-23的变化情况。组间数据比较采用单因素方差分析（one-way ANOVA）和LSD-t检验进行。结果门静脉高压症患者脾切除术前CD3、CD4、CD8、CD4/CD8值明显低于正常对照组（P均<0.01）,Th17细胞及其相关炎症因子IL-6、IL-17、IL-23水平显著高于正常对照组（P均<0.01）。门静脉高压症患者脾切除术后7 d、术后1个月、3个月的CD3、CD4、CD8、CD4/CD8值均先降低后升高,术后7 d的CD3、CD4、CD8、CD4/CD8值低于术前水平（P均<...
- 脾切除术 /
- 高血压,门静脉 /
- 免疫活性 /
- T淋巴细胞,辅助诱导
Abstract:
Objective To investigate the effects of splenectomy on peripheral immune cells including Th17 cells in patients with portal hypertension and to analyze the influence of splenectomy on their immune function. Methods Twenty- five portal hypertension patients treated with splenectomy in No. 180 Hospital of PLA from June 2012 to June 2014 were selected as observation group, and 25 healthy controls who underwent physical examination in the same period as control group. Flow cytometry was used to determine the percentages of CD3, CD4, and CD8 T lymphocytes, CD4 /CD8 ratio, and percentage of Th17 cells in the peripheral blood of portal hypertension patients ( 1 day before operation and at 7 days, 1 month, and 3 months after operation) and healthy controls. ELISA was used to evaluate the changes in serum interleukin- 6 ( IL- 6) , interleukin- 17 ( IL- 17) , and interleukin- 23 ( IL- 23) . Comparison between groups was made by one-way ANOVA and LSD- t test. Results Before splenectomy, the portal hypertension patients had significantly lower percentages of CD3, CD4, and CD8 T lymphocytes and CD4 /CD8 ratio ( P < 0. 01 for all) and significantly higher percentage of Th17 cells and levels of their associated inflammatory cytokines ( IL- 6, IL- 17, and IL- 23) ( P < 0. 01 for all) , as compared with the control group. At 7 days, 1month, and 3 months after operation, the percentages of CD3, CD4, and CD8 T cells and CD4 /CD8 ratio in portal hypertension patients first decreased and then increased, and these values were significantly lower at 7 days after operation than before operation ( P < 0. 01 for all) ; at3 months after operation, the patients showed no significant differences in the percentages of CD3, CD4, and CD8 T cells and CD4 /CD8 ratio compared with the control group ( P > 0. 05 for all) . At 7 days, 1 month, and 3 months after operation, the percentage of Th17 cells and levels of their associated inflammatory cytokines ( IL- 6, IL- 17, and IL- 23) in portal hypertension patients decreased gradually ( P <0. 05 for all) . Conclusion Th17 cells and their associated inflammatory cytokines ( IL- 6, IL- 17, and IL- 23) are reduced in portal hypertension patients treated with splenectomy, so their immune function can be improved.
- splenectomy /
- hypertension, portal /
- immunocompetence /
- T-Lymphocytes, helper-inducer

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参考文献(12)

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[12]NOMURA Y, KAGE M, OGATA T, et al.Influence of splenectomy in patients with liver cirrhosis and hypersplenism[J].Hepatol Res, 2013.[Epub ahead of print]引证本文:LIU CH, CHEN YJ, ZHANG CH.Effects of splenectomy on peripheral blood Th17 cells and immune function in patients with portal hypertension[J].J Clin Hepatol, 2014, 30 (9) :887-890. (in Chinese) 刘朝辉, 陈一杰, 张诚华.脾切除对门静脉高压症患者外周血中Th17细胞及免疫功能的影响[J].临床肝胆病杂志, 2014, 30 (9) :887-890.

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