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存在残留脾脏组织时的免疫功能障碍。

Immune dysfunction in the presence of residual splenic tissue.

作者信息

Cohen R C, Ferrante A

出版信息

Arch Dis Child. 1982 Jul;57(7):523-7. doi: 10.1136/adc.57.7.523.

Abstract

Immunological function was examined in children who had undergone splenectomy, in 8 for trauma, and in 11 for haematologic/oncologic reasons. Particular emphasis was placed on the effects of residual splenic tissue on immune function. Children in the elective group had no evidence of splenosis but 6 of the 8 trauma patients showed residual splenic activity. A general trend indicated that immunological dysfunction was associated with the presence of residual splenic tissue. Three patients with significant post-traumatic splenosis showed low IgM levels, one also had a low IgG level and another a low IgA and impaired lymphocyte response to mitogens. The trauma patients with little or no splenic tissue had normal immune functions. Immunological abnormalities were found in 8 of the 11 haematologic/oncologic patients with no splenosis suggesting the abnormalities were possibly due to the primary disease. In contrast to the popular belief that splenosis confers protection against overwhelming sepsis, the present findings suggest that patients with residual splenic tissue are at a greater risk of infection because of a lower level of immune response.

摘要

对因外伤行脾切除术的8例儿童以及因血液学/肿瘤学原因行脾切除术的11例儿童的免疫功能进行了检查。特别强调了残余脾组织对免疫功能的影响。择期手术组的儿童没有副脾的证据,但8例外伤患者中有6例显示有残余脾组织活性。总体趋势表明,免疫功能障碍与残余脾组织的存在有关。3例创伤后副脾明显的患者IgM水平较低,1例患者IgG水平也较低,另1例患者IgA水平较低且淋巴细胞对丝裂原的反应受损。脾组织很少或没有脾组织的外伤患者免疫功能正常。11例无副脾的血液学/肿瘤学患者中有8例发现免疫异常,提示这些异常可能是由原发性疾病引起的。与普遍认为副脾可预防暴发性败血症的观点相反,目前的研究结果表明,有残余脾组织的患者由于免疫反应水平较低,感染风险更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45db/1627690/103ba3f1e69e/archdisch00756-0047-a.jpg

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