Peregud-Pogorzelski Jarosław, Brodkiewicz Andrzej, Gontarewicz Artur, Szychot Elwira, Pawluch Lucyna, Machaliński Bogusław
I Klinika Chorób Dzieci Katedry Chorób Dzieci Pomorskiej Akademii Medycznej w Szczecinie.
Pol Merkur Lekarski. 2003 Nov;15(89):432-5.
The authors would like to point out a possibility of immune system disturbances (especially lymphocyte T), severe infection occurring in patients following splenectomy. Five children following splenectomy due to severe spherocytosis were studied. In all children serum level of IgA, IgG, IgM immunoglobulins, phagocytic index, Hamburger count and lymphocyte antigen surface expression CD3, CD4 CD10, CD19, CD20, CD29, CD45RA, CD56 were evaluated. In comparison to control group, median numbers of lymphocyte T CD3 (p < 0.05), lymphocyte CD4 (p < 0.05), lymphocyte T CD4CD29 (p < 0.001) and percentage of cells reacting with z CD4CD45RA (p < 0.001) were significantly lower in splenectomized children, whereas number of NK cells occurred to be noticeable higher (p < 0.001). Immunoglobulins' levels, Hamburger count, phagocytic index and percentage of lymphocyte CD8, CD19 and CD20 did not differ between groups. On the basis of the results, the authors recommend the necessity of routine vaccination in this group of patients against most common pathogens.
作者想要指出脾切除术后患者出现免疫系统紊乱(尤其是T淋巴细胞)及严重感染的可能性。对5例因严重球形红细胞增多症而行脾切除术的儿童进行了研究。对所有儿童评估了血清中IgA、IgG、IgM免疫球蛋白水平、吞噬指数、汉伯格计数以及淋巴细胞抗原表面标志物CD3、CD4、CD10、CD19、CD20、CD29、CD45RA、CD56的表达。与对照组相比,脾切除儿童的T淋巴细胞CD3中位数(p<0.05)、淋巴细胞CD4中位数(p<0.05)、淋巴细胞T CD4CD29中位数(p<0.001)以及与z CD4CD45RA反应的细胞百分比(p<0.001)显著降低,而自然杀伤细胞数量明显更高(p<0.001)。两组之间免疫球蛋白水平、汉伯格计数、吞噬指数以及淋巴细胞CD8、CD19和CD20的百分比无差异。基于这些结果,作者建议该组患者有必要针对最常见病原体进行常规疫苗接种。