丙型肝炎病毒感染相关肝硬化患者中病毒载量降低诱导的脾切除术
Reduction of virus burden-induced splenectomy in patients with liver cirrhosis related to hepatitis C virus infection.
作者信息
Sekiguchi Tetsuro, Nagamine Takeaki, Takagi Hitoshi, Mori Masatomo
机构信息
Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan.
出版信息
World J Gastroenterol. 2006 Apr 7;12(13):2089-94. doi: 10.3748/wjg.v12.i13.2089.
AIM
To examine the hepatitis C virus (HCV) levels and immunological markers in cirrhotic patients after splenectomy.
METHODS
HCV RNA titers as well as cellular and humoral immune markers were determined in 20 cirrhotic patients after splenectomy and in 32 cirrhotic controls with an intact spleen.
RESULTS
Serum HCV RNA titers were lower in the splenectomized patients than in the controls (186+/-225 x 10(3)copies/mL vs 541+/-417 x 10(3) copies/mL, P<0.01). HCV RNA was judged to have been spontaneously eradicated in 4 splenectomized patients, but in none of the controls. Natural killer cell activity was higher in the splenectomized patients than in the controls (41.2+/-19.3% vs 24.7+/-15.3%, P<0.01), and natural killer cell activity was negatively correlated to HCV RNA titers in the splenectomized patients except in those with serotype 2-related infection. The CD4/CD8 ratio was significantly lower in the splenectomized patients than in the controls.
CONCLUSION
The findings suggest that splenectomy may diminish virus burden in cirrhotic patients with HCV infection at least in part, through augmentation of natural killer cell activity.
目的
检测脾切除术后肝硬化患者的丙型肝炎病毒（HCV）水平及免疫标志物。
方法
测定20例脾切除术后肝硬化患者及32例脾脏完整的肝硬化对照患者的HCV RNA滴度以及细胞免疫和体液免疫标志物。
结果
脾切除患者的血清HCV RNA滴度低于对照组（186±225×10³拷贝/mL对541±417×10³拷贝/mL，P<0.01）。4例脾切除患者的HCV RNA被判定为自然清除，但对照组无此情况。脾切除患者的自然杀伤细胞活性高于对照组（41.2±19.3%对24.7±15.3%，P<0.01），且除2型血清型相关感染患者外，脾切除患者的自然杀伤细胞活性与HCV RNA滴度呈负相关。脾切除患者的CD4/CD8比值显著低于对照组。
结论
研究结果表明，脾切除术可能至少部分通过增强自然杀伤细胞活性减轻HCV感染肝硬化患者的病毒负荷。
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