The Impact Of Splenectomy Plus Pericardial Devascularization To Th17Cells In Chronic Hepatitis B Cirrhosis Patients

Objective: Th17was a new found cell in recent years that speciallysecreted IL-17(interleukin17,IL-17). Its biological function and differentiationwas different from Th1and Th2cells. There were a lot of studies inautoimmune diseases, transplant rejection and cancer about Th17cells. But theresearch about Portal Hypertension(PHT) and Hypersplenism which wascaused by Chronic Hepatitis B Cirrhosis was rarely found. Some things needto be explored, such as the Th17levels of Chronic Hepatitis B CirrhosisPatients, the changes of Th17cells after Splenectomy and whether Th17cellscould reflet the liver condition while eliminating the HBV. In addition, thecontroversy of the changes in immune system after Splenectomy proposed thequestion about retention or removal of the spleen. In the present study, weexamined the normal persons and patients’ peripheral Th17cell levels boforeand after Splenectomy plus Pericardial Devascularization, in order to clarifythe correlation between liver inflammation and Th17cells, and the role ofTh17cells in the immune system before and after operation.Methods:11normal persons and11patients’ peripheral blood beforesurgery,1week after surgery,1month after surgery and3month after surgerywere collected. Then Th17cells were detected by flow cytometric and liverfunction were detected by automatic biochemical analyzer. At last, wecompared Th17cells between patients and normal controls and Th17cells inpatients on various time point, as well as did a correlation analysis.Results：1.Th17cell frequency of case group(3.04±0.59)%wassignificantly higher than nomal controls(1.43±0.54)%(P<0.01).2. Comparedwith preoperation, The Th17cell frequency of the patients in1week aftersurgery was (2.39±0.78)%, in1month after surgery was (1.78±0.57)%andin3month after surgery was (1.55±0.51)%. The Th17cell frequency was gradually reduced(P<0.05).3. The Th17cell frequency was positivelycorrelated with the ALT(r=0.408P=0.002) and AST(r=0.617P=0.000) of theliver function, and had no correlation with TBIL, DBIL, IBIL.Conclusions：1.The Th17cell frequency in peripheral blood of thepatients with chronic hepatitis B was higher than nornal controls.2.The Th17cell frequency of the patients with Portal Hypertension and Hypersplenismhad a gradually reduction in three months after Splenectomy plus PericardialDevascularization, while had a positive correlation with live enzymes.3.Immune system in patients of Chronic Hepatitis B Cirrhosis Patients withPortal Hypertension and Hypersplenism was disordered, whlie the Th17cellswere significantly higher. In3months after the operation, Th17cells reductionreflected that immune system disorder had improved and there’s no necessaryto retain part of the spleen.4. Th17cells may become a new target for thetreatment of CHB.