Zoli G, Corazza G R, D'Amato G, Bartoli R, Baldoni F, Gasbarrini G
Istituto Patologia Medica, Università di Bologna, Italy.
Br J Surg. 1994 May;81(5):716-8. doi: 10.1002/bjs.1800810530.
This study set out to determine the relationship between splenic function (as assessed by the percentage of pitted red cells) and tuftsin activity, and to confirm the return of effective splenic function after splenectomy for trauma. Twenty-three patients (13 men) took part. Ten of mean age 48.5 (range 30-74) years had had the spleen removed for traumatic rupture and 13 of mean age 49.7 (range 23-66) years had undergone elective splenectomy. At the time of the study all patients had had the spleen removed a minimum of 1 year previously (mean 6.1 (range 1-15) years). Fifty healthy volunteers matched for sex and age were also studied. In each subject, residual splenic function was evaluated by counting the percentage of pitted red cells. Tuftsin activity was also determined. A highly significant negative correlation was found between pitted red cell percentage and tuftsin activity (rs = -0.80, P < 0.001). Compared with healthy controls (mean 21.6 (range 13-37) per cent), tuftsin activity was significantly reduced both in patients who had undergone splenectomy for trauma (mean 4.4 (range 0-9) per cent; P < 0.0001) and in those who had had elective splenectomy (mean 0; P < 0.0001). Tuftsin activity was significantly (P < 0.001) more depressed after elective than traumatic splenectomy. These data confirm a decrease in tuftsin activity following splenectomy and show that this deficit is significantly greater after elective than emergency removal. These observations confirm that residual splenic function is often present after traumatic splenectomy.
本研究旨在确定脾功能(通过去核红细胞百分比评估)与促吞噬素活性之间的关系,并证实创伤性脾切除术后有效脾功能的恢复情况。23名患者(13名男性)参与了研究。10名平均年龄48.5岁(范围30 - 74岁)的患者因外伤性破裂切除了脾脏,13名平均年龄49.7岁(范围23 - 66岁)的患者接受了择期脾切除术。在研究时,所有患者均在至少1年前切除了脾脏(平均6.1年,范围1 - 15年)。还对50名年龄和性别匹配的健康志愿者进行了研究。在每个受试者中,通过计算去核红细胞的百分比来评估残余脾功能。同时也测定了促吞噬素活性。发现去核红细胞百分比与促吞噬素活性之间存在高度显著的负相关(rs = -0.80,P < 0.001)。与健康对照组(平均21.6%,范围13 - 37%)相比,因创伤接受脾切除术的患者(平均4.4%,范围0 - 9%;P < 0.0001)和接受择期脾切除术的患者(平均0;P < 0.0001)的促吞噬素活性均显著降低。择期脾切除术后促吞噬素活性的降低比创伤性脾切除术后更显著(P < 0.001)。这些数据证实了脾切除术后促吞噬素活性降低,并且表明这种缺陷在择期切除后比急诊切除后明显更大。这些观察结果证实了创伤性脾切除术后通常存在残余脾功能。