The Effect Of Liver Function And Fibrosis Cytokines In Patients With Liver Cirrhosis After Splenectomy

Objective:Through detecting the liver function, platelet, liver fibrotic markers levels and the expression of serum fibrosis cytokines in patients with liver cirrhosis after splenectomy, explore the effect of liver function and serum fibrosis cytokines in patients with liver cirrhosis after splenectomy and study the mechanism of liver cirrhosis in varying degrees of hypersplenism.Methods:Collected the clinical data of 60 patients with liver cirrhosis after splenectomy. The clinical data included plasma blood cells count, liver function and serum content of liver fibrotic markers (HA, LN, PC-Ⅲ, Ⅳ-C). The patients were divided into three experimental groups:mild hypersplenism group, moderate hypersplenism group and severe hypersplenism group. Collecting their blood sample before and after operation, respectively at preoperative and postoperative a week, three months. The control group contains fifteen healthy individuals, and their blood sample was also collected. Using ELISA to test the serum PDGF and TGF-β1. At last, we analysis the results between different groups.Results:1. It was found that albumin significantly decreased at a week after splenectomy (P< 0.05). And after three months, albumin recovered to preoperative level. The serum content of ALT, AST significantly decreased at a week after splenectomy (P< 0.05). The serum content of total bilirubin significantly decreased at three months after splenectomy(P< 0.05);2. The counts of platelets, white blood cells, neutrophilicgranulocytes and lymphocytes significantly rasied at a week, three months after splenectomy(P< 0.05). The counts of red blood cells, Hb had no significant differences before and after splenectomy(P> 0.05);3. The serum content of HA, PC-Ⅲ and Ⅳ-C decreased after splenectomy, and the serum content at a week, three month was significantly different from preoperative level (P< 0.05);4. The serum content of PDGF and TGF-β1 in liver cirrhosis groups was significant higher than the control group (P< 0.05). There was significant difference between the three liver cirrhosis groups (P< 0.05). With the increasing degree of hypersplenism, the serum content of PDGF and TGF-β1 significantly was raised (P< 0.05);5. The serum content of PDGF and TGF-β1 decreased after splenectomy, and the serum content at a week, three month was significant different from the preoperative level (P< 0.05);6. There was a significantly negative correlation between PDGF and the count of platelets (P< 0.05); There was a significantly negative correlation between TGF-β1 and the count of platelets (P<0.05).Conclusions:1. The splenectomy is helpful to cure hypersplenism, elevate the count of platelets and improve the coagulation function in patients with hypersplenism;2. The splenectomy is advantageous to decrease the serum content of HA, PC-Ⅲ and Ⅳ-C in patients with hypersplenism. It may reduce the degree of hepatic fibrosis;3. The destruction of platelets increased in patients with hypersplenism, and it caused the increasing expression of PDGF and TGF-β1. But after splenectomy the destruction of platelets decreased, so did the expression of PDGF and TGF-β1. It seemed that splenectomy could inhibit the expression of PDGF. and TGF-β1 and reduce the degree of hepatic fibrosis through reducing destruction of platelets.