自体脾移植术后移植脾存活与免疫功能恢复的相关性研究

摘要

Objective:To evaluate clinical significance of the survival of the transplanted spleen to the recovery of immune function after spleen autotransplantation. Methods:24 cases of splenectomy for traumatic splenic rupture and spleen auto-transplantation were Retrospective analyzed. All the transplanted spleens were put in omentum and grew to different de-grees. Each case was rechecked with abdominal CT,the growth of the transplanted spleens was observed and the values of IgG,IgM,IgA and C3 were obtained in the first month and fourth month after the surgery,and were divided into groups A and B for statistical analysis. Group A included the values of the first month and group B is the values of the fourth month after surgery. Results:The values of IgG,IgM,IgA and C3 in group A were(2. 549 ± 0. 495)g·L-1 ,(0. 276 ± 0. 057)g·L-1 ,(0. 395 ± 0. 049)g·L-1 ,and(0. 284 ± 0. 069)g·L-1 respectively,while The values of group B were (5. 638 ± 1. 069)g·L-1 ,(1. 106 ± 0. 173)g·L-1 ,(0. 963 ± 0. 217)g·L-1 ,and(0. 815 ± 0. 136)g·L-1 respec-tively. T There was statistically significant difference(p<0. 05). Conclusions:Spleen autotransplantation is a good way to protect spleen. The survival of the transplanted spleen is closely correlative to the recovery of immune function. The higher the survival rate of the transplanted spleen is,the better the immune function recovers. So,autologous spleen transplantation should be operated for the patients who do not meet the demands of pure splenectomy or partial splenecto-my in order to improve the quality of life after their surgery.%目的：评价自体脾移植术后移植脾存活情况对免疫功能恢复的作用及临床意义。方法：回顾性分析24例因脾破裂行脾切除加自体脾移植术的病例，移植脾均置于大网膜囊中并有不同程度生长，并于术后1个月及4个月复查腹部CT，观察移植脾生长情况。分别获取术后1个月及4个月的IgG、IgM、IgA及C3值，分为A、B两组，A组为术后1个月IgG、IgM、IgA及 C3值，B组为术后4个月IgG、IgM、IgA及C3值，进行统计学分析。结果：A组IgG、IgM、IgA、C3值分别为（2.549±0.495）g·L-1、（0.276±0.057）g·L-1、（0.395±0.049）g·L-1、（0.284±0.069）g·L-1。B组分别为（5.638±1.069）g·L-1、（1.106±0.173）g·L-1、（0.963±0.217）g·L-1、（0.815±0.136）g·L-1，差异均有统计学意义（ p<0.05）。结论：自体脾移植术是一种良好的保脾手术方式，而移植脾的存活情况与免疫功能的恢复密切相关，移植脾存活越好，免疫功能恢复也越好。对不符合行单纯脾切除手术及脾部分切除的患者应尽量采取此种术式，以提高患者预后生活质量。