Analysis of laboratory indicators of splenectomy on improvement of liver function in patients with Wilson's disease

ObjectiveTo investigate the effect of splenectomy on liver function in patients with Wilson's disease (WD).

MethodsA total of 97 WD patients were divided into normal spleen group, splenomegaly group and hypersplenism group according to abdominal two-dimensional color ultrasound and platelet count, and 31 healthy physical examiners were used as control group during the same period.The differences in liver function indexes between groups were compared.Splenectomy was performed in 28 patients with hypersplenism, and the differences in liver function indicators before and after surgery were compared.

ResultsExcept for aspartate aminotransferase mitochondrial isoenzyme (m-AST) and lactate dehydrogenase (LDH) had no significant difference between the groups (P>0.05), the other liver function indexes were statistically significant in each group (P < 0.05 to P < 0.01).Compared with the control group, the total bile acid (TBA) and activated partial thromboplastin time (APTT) were increased, and the prealbumin (PA) and hemoglobin (Hb) were reduced in the normal spleen group; compared with the normal spleen group, total bilirubin (TBIL), direct bilirubin (DBIL), indirect bilirubin (IBIL), total bile acid (TBA), alkaline phosphatase (ALP), adenosine deaminase (ADA), prothrombin time (PT), and APTT were increased in the splenomegaly group, and PA, serum fibronectin (FN), and PLT were reduced.Compared with the splenomegaly group, the aspartate aminotransferase (AST), DBIL, TBA, ADA, PT, APTT and the thrombin time (TT) were increased in the hypersplenism group, and PA, FN, total cholesterol (T-CHO), white blood cell count (WBC), red blood cell count (RBC), Hb, PLT were reduced, and the differences were statistically significant (P < 0.05).TBIL, DBIL, IBIL, TBA, ADA, PT, APTT and TT levels decreased compared with preoperative levels in hypersplenism patients with WD 14 days after splenectomy, total protein, albumin, FN, T-CHO, WBC, PLT, alanine aminotransferase, AST, m-AST, γ-glutamyltransferase and LDH were significantly higher than those before surgery (P < 0.01).

ConclusionsAfter splenectomy, liver synthesis function and liver metabolic function are significantly improved.Excluding short-term factors of surgical trauma, hepatocyte damage and membrane permeability are also improved, and splenectomy can significantly improve liver function in patients with WD hypersplenism.