中文摘要：

目的观察门静脉高压症（PH）脾亢脾脏巨噬细胞（MФ）数量及其吞噬功能的变化，为进一步探讨PH脾功能亢进（脾亢）的发病机制提供依据。方法取20例PH脾亢患者的手术脾脏作为PH组，按脾脏肿大程度的分级标准，再分为中度肿大组（11例）和重度肿大组（9例）。6例正常脾外伤性破裂患者的手术脾脏作为对照组。称重后贴壁法分离培养脾脏MФ，用细胞计数板在显微镜下计数MФ的相对数（每g脾脏组织中的MФ数）并计算MФ绝对数（整个脾脏内MФ的总数），鸡红细胞吞噬法计算MФ的吞噬率和吞噬指数。结果对照组、PH中度和重度脾大组MФ的相对数分别为（13．13±3．72）×10^5／g、（8．80±0.97）×10^5／g、（7．29±1．33）×10^5／g，PH组比对照组均显著减少（P〈0．01），但PH的两组之间差异无统计学意义（P〉0．05）；PH组脾脏的重量明显增加（P〈0．01），可达正常脾重的3．5～6．0倍（放血后）；各组MФ的绝对数分别为（1．94±0．55）×10^8、（4．91±1．12）×10^8、（6．86±0．77）×10^8，PH组比对照组均显著增多（P〈0．01），且PH重度肿大组也显著多于中度肿大组（P〈0．01）；各组MФ的吞噬率和吞噬指数分别为（6.33±0.58）％和（0．07±0．01）、（11．25±2.19）％和（0．14±0．03）、（13．00±2.38）％和（0．16±0．04），PH组比对照组均显著增强（P〈0.01），但PH的两组之间比较差异无统计学意义（P〉0.05）。结论PH脾亢时，脾脏MФ的相对数虽然减少，但绝对数增多，MФ的吞噬功能增强。MФ在PH脾亢的形成中可能扮演着非常重要的角色。进一步支持了脾亢发病中的“脾内阻留学说”。

英文摘要：

Objective To investigate the change of quantity and phagocytosis of splenic macrophages （MФ） in patients with portal hypertension （PH）-associated hypersplenism,and explore the role of the splenic MФ in the formation of PH hypersplenism. Methods Twenty spleens resected from the patients with PH hypersplenism served as PH group. According to the standard of splenomegaly, they were divided into two groups：medium splenomegaly group （n = 11 ） and great splenomegaly group （n = 9 ）. The spleens from 6 cases of traumatic spleen rupture were regarded as control group. The spleens were weighed, and the MФ were purified from spleens and cultured in order to detect the relative quantity （the MФ number of each gram spleen）, total quantity （the MФ number of the whole spleen） and their phagocytosis. Results The relative quantity of MФ in control group, medium splenomegaly group and great splenomegaly group was （13.13 ± 3.72） ×10^5/g, （8.80 ± 0.97） ×10^5/g, （7.29 ± 1.33） ×10^5/g respectively. The relative quantity of MФ in the PH groups was decreased significantly as compared with that in the control group （P〈0.01）, and no difference was found between two splenomegaly groups （ P 〈 0.05 ）. The splenic weight in the PH groups was 3.5-6.0 times that of control group （ P 〈 0.01 ）. The total quantity of MCb in control group, medium and great splenomegaly groups was （ 1.94± 0.55 ） ×10^8,（4.91 ± 1.12） ×10^8 and （6.86± 0.77） ×10^8 respectively. The total quantity of MФ in the PH groups was increased significantly as compared with that in the control group （ P 〈 0.01）, and that in great splenomegaly group was increased significantly as compared with that in medium splenomegaly group （P〈0.01）. The phagocytosis rate and phagocytosis index of MФ in control group, medium and great splenomegaly groups were （6.33 ± 0.58） % and （0.07 ± 0.01 ）, （11.25 ± 2.19） % and （0.14 ±0.03）, and （13.00 ± 2.38） % and （0.16 ± 0.04）