Rab Minke A E, Meerveld-Eggink Aafke, van Velzen-Blad Heleen, van Loon Douwe, Rijkers Ger T, de Weerdt Okke
Department of Internal Medicine, St. Antonius Hospital, Nieuwegein, The Netherlands.
Department of Internal Medicine and Dermatology, University Medical Centre Utrecht, Van Creveldkliniek, Heidelberglaan 100, 3508 GA, Utrecht, The Netherlands.
Int J Hematol. 2018 Feb;107(2):157-165. doi: 10.1007/s12185-017-2335-9. Epub 2017 Sep 26.
The effect of splenectomy on the incidence of infections and thromboembolisms has been investigated thoroughly. Nevertheless, the long-term effects of splenectomy on immunological profile and circulating blood counts have not been described before. To study such long-term effects, we analysed several parameters in splenectomised trauma patients and compared the results of this group ("otherwise healthy patients") to patients with a specific underlying disease. We measured platelet count, leukocytes and differential, lymphocyte subsets, serum levels of immunoglobulins, and complement pathways in 113 patients. Indications to perform a splenectomy were trauma (n = 42), Hodgkin lymphoma (n = 24), hereditary spherocytosis (n = 21), and immune thrombocytopenia (n = 26). In trauma patients lymphocytes and lymphocytes subsets were particularly elevated compared to normal population values. Splenectomised patients with Hodgkin lymphoma had significant lower numbers of T lymphocytes than trauma patients. Significant increases in platelets, leukocytes, and monocytes were observed in patients with hereditary spherocytosis. Occurrence of MBL genotype was different in ITP patients than in other splenectomised groups and the normal population. In splenectomised patients (> 4 years), platelet counts and lymphocyte subsets are increased which persist over time. As a result, these blood counts in splenectomised patients differ from reference values in the normal population.
脾切除术对感染和血栓栓塞发生率的影响已得到充分研究。然而，脾切除术对免疫特征和循环血细胞计数的长期影响此前尚未见报道。为研究此类长期影响，我们分析了脾切除术后创伤患者的几个参数，并将该组患者（“其他健康患者”）的结果与患有特定基础疾病的患者进行了比较。我们测量了113例患者的血小板计数、白细胞及其分类、淋巴细胞亚群、免疫球蛋白血清水平和补体途径。进行脾切除术的指征包括创伤（n = 42）、霍奇金淋巴瘤（n = 24）、遗传性球形红细胞增多症（n = 21）和免疫性血小板减少症（n = 26）。与正常人群值相比，创伤患者的淋巴细胞和淋巴细胞亚群尤其升高。霍奇金淋巴瘤脾切除患者的T淋巴细胞数量明显低于创伤患者。遗传性球形红细胞增多症患者的血小板、白细胞和单核细胞显著增加。免疫性血小板减少症患者的MBL基因型发生率与其他脾切除组及正常人群不同。在脾切除患者（>4年）中，血小板计数和淋巴细胞亚群增加，且随时间持续存在。因此，脾切除患者的这些血细胞计数与正常人群的参考值不同。
