Objective: To study humoral and cellular immune function change among cirrhosis with different spleen-liver ratio, in order to provide a relative reference index of spleen-volume-preservation in Spleen-preserving surgery. Methods: With CLIA and flow cytometry, humoral immune index (IgA, IgG and IgM ) and cellular immune index (the ratio of Treg cells to CD4 + T cell) were observed in hepatocirrhosis patients with the different spleen-liver ratio and control group. Results: There were no statistically significant difference between serum levels of IgA, IgG and IgM in hepatocirrhosis group and healthy group, but IgM was higher in hepatocirrhosis group (spleen-liver ratio >0. 8) ,and control group. Compared with hepatocirrhosis group (spleen-liver ratio ≤0. 8) ,and difference had statistical significance. P value was 0. 000 and 0. 003 respectively. Treg cell to CD4 + cell number ratio was higher in hepatocirrhosis group ( spleen-liver ratio ≥0. 6 ) , compared with control group and hepatocirrhosis group ( spleen-liver ratio < 0. 6 ) . P value was 0. 022 and 0. 018. Conclusion: When spleen-liver ratio >0. 8 , humoral immune function, especially primary immune response, decreased obversly; when spleen-liver ratio ≥ 0. 6,there were cellular immune dysfunction in patient. So we think,according to the immune function,a range from 0. 6 to 0. 8 of spleen-liver ratio were regarded as a reference index in Spleen-preserving surgery.%目的:观察肝硬化患者不同脾肝体积比的体液及细胞免疫功能变化,为保脾手术提供保留脾脏体积的相对参考指标.方法:监测不同脾肝体积比患者的体液及细胞免疫学指标,并和健康对照组比较.结果:肝硬化组与健康对照组的IgA、IgG和IgM没有明显的统计学差异,但脾肝体积比＞0.8组与健康对照组和脾肝体积比≤0.8组相比较,则有明显的统计学差异,P值分别为0.000和0.003；脾肝体积比≥0.6组和脾肝体积比＜0.6组及健康对照组的Treg细胞占CD4+细胞比例比较,有明显的统计学差异,P值分别为0.022和0.018.结论:当脾肝体积比＞0.8时,体液免疫功能尤其是初级免疫应答能力明显下降,在脾肝体积比≥0.6时,机体细胞免疫功能出现紊乱,因此考虑是否可以将保留的脾脏体积控制在0.6～0.8以内作为行保脾手术中保留脾脏体积的一个参考.
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