关键词: 经颈静脉肝内门体分流术, T细胞亚群, 肝性脑病, 门静脉高压症

Abstract: Objective To explore the effect of transjugular intrahepatic portosystemic shunt (TIPS) on peripheral blood T cell subsets of perioperative patients with portal hypertension. Methods A retrospective analysis was conducted on patients with portal hypertension who underwent TIPS from May 2023 to August 2023. The changes in peripheral blood T cell subsets before and after TIPS was analyzed. Results The study included a total of 22 patients, with a preoperative pressure gradient (PPG) of 23.64 ± 6.8 mmHg and a postoperative PPG of 9.27 ± 4.7 mmHg (P<0.05); Preoperative blood ammonia levels were 74.38±31.30 μg/dL, and postoperative blood ammonia levels were 88.43+42.20 μg/dL. There was no statistically significant difference in postoperative blood ammonia levels. The changes in postoperative lymphocytes, CD8⁺ T cell/lymphocyte ratio, and T cell/lymphocyte ratio showed statistical differences (P<0.05). Postoperative follow-up revealed that 2 patients died and 6 (27%) had obvious hepatic encephalopathy. Through comparison, it was found that patients with hepatic encephalopathy had a significantly reduced number of lymphocytes after surgery compared to patients without hepatic encephalopathy (431.9±493.8 vs. 65.5±247.2, P=0.031). Conclusion The T cell subpopulations in patients after TIPS operation may change and this may be associated with the occurrence of hepatic encephalopathy in these patients.

Key words: Transjugular intrahepatic portosystemic shunt, T cell subpopulations, Hepatic encephalopathy, Portal hypertension