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目前,许多国外学者均认为,切脾后败血症(PSS)直接与切脾有关,即使败血症及早诊断与适当治疗仍有50～75％的患者死亡。一般是切脾时的年龄越小与术前的疾病越严重,则发生PSS的危险性越大。现将切脾与免疫及感染的关系简述如下。脾脏防治感染的功能脾对于侵入血液的细菌为一道重要防御线,因①脾能产生抗体,切脾后一致认为IgM抗体明显减少,这对初级免疫,特别是对有荚膜多糖类抗原的肺炎双球菌的清除力降低:②脾内巨噬细胞能捕捉细菌及其抗原,并将其清除;③脾能产生一种四肽(Tuftisin)与中性粒细胞结合,并刺激其活性;④脾能产生裂解素,它是激活补体旁路途径的重要成分。
At present, many foreign scholars believe that post-splenectomy sepsis (PSS) is directly related to splenectomy, even if the early diagnosis and proper treatment of sepsis is still 50 to 75% of patients died. In general, the smaller the age at splenectomy and the more severe preoperative disease, the greater the risk of developing PSS. Now the relationship between spleen and immune and infection is summarized as follows. Spleen function of the prevention and treatment of spleen invasion of blood for the bacteria is an important line of defense, due to the spleen can produce antibodies, spleen after the unanimous reduction of IgM antibodies, which for primary immunity, especially for capsular polysaccharide antigen Streptococcus pneumoniae reduce the scavenging capacity: ② spleen macrophages can capture bacteria and their antigens, and remove; ③ spleen can produce a tetrapeptide (Tuftisin) and neutrophils, and stimulate its activity; ④ The spleen produces lysin, which is an important component of the complement bypass pathway.