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本文用普通酵母菌对44例门脉性肝硬化患者、10例慢性迁延型肝炎患者以及38例正常人进行中性粒细胞吞噬及细胞内杀菌功能试验,结果,38例正常人中性粒细胞吞噬率及杀伤率均值分别为23±7及39±3,而44例肝硬化患者即为15±5及30±7,明显低于正常对照组(P<0.001).而24例失代偿期肝硬化与12例代偿期肝硬化患者,8例肝硬化合并肝癌者与36例未合并肝癌肝硬化者吞噬及杀伤功能无差异.慢迁肝患者吞噬及杀菌能力高于正常对照组(P<0.05),但高于肝硬化组(P<0.001).肝硬化对中性粒细胞功能的影响机理尚不清楚.本组44例肝硬化患者中15例检测了IgA及10例检测了C_3含量,结果表明,15例患者IgA高于正常值,10例C_3含量低于正常值具有统计学意义(P<0.001).由此推测,本组肝硬化患者吞噬及杀菌功能异常似与IgA升高和(或)C_3降低有关.IgA升高抑制了中性粒细胞吞噬作用抑或与抗原形成抗原抗体复合物,后者封闭了中性粒细胞Fc和C_3受体,致使被调理的微生物不能被中性粒细胞所吞噬或杀伤.C_3b由C_3裂解而来,C_3降低势必导致C_3b减少,结果微生物因C_3b减少而不能被调理,不能被中性粒细胞吞噬及杀伤.因此本试验也提示了,肝硬化患者易感染性与他们中性粒细胞吞噬及杀菌功能减退有一定的联系.
In this paper, 44 patients with portal vein cirrhosis, 10 patients with chronic persistent hepatitis and 38 normal subjects were tested for their neutrophil phagocytosis and intracellular bactericidal activity using ordinary yeasts. As a result, 38 normal human neutrophils The mean rate of phagocytosis and killing was 23 ± 7 and 39 ± 3, respectively, while that of 44 cirrhotic patients was 15 ± 5 and 30 ± 7, significantly lower than that of the normal control group (P <0.001) There were no differences in the phagocytic and cytotoxicity between cirrhosis and cirrhosis in 12 patients with cirrhosis and in 8 patients with cirrhosis and 36 patients without cirrhosis P <0.05), but higher than the cirrhosis group (P <0.001) .The mechanism of the effect of cirrhosis on the neutrophil function is unclear.Among the 44 patients with cirrhosis, 15 cases detected IgA and 10 cases detected C_3 content, the results showed that IgA in 15 patients was higher than the normal value, 10 cases of C_3 content was lower than the normal value was statistically significant (P <0.001) .Thus, this group of patients with liver cirrhosis phagocytosis and bactericidal function similar to IgA Elevated and / or decreased C_3.IgA increased inhibition of neutrophil phagocytosis or antigen-forming antigen Body complex, which blocks the neutrophil Fc and C_3 receptors, resulting in conditioning of microorganisms can not be phagocytosed or killed by neutrophils.C_3b cleavage from C_3, C_3 reduction will inevitably lead to C_3b reduction, the results of microorganisms Because C_3b reduction can not be conditioning, can not be phagocytized and killed by neutrophils.Therefore, this study also suggests that patients with cirrhosis susceptibility to neutrophil phagocytosis and sterilization have some contact.