Abstract
目的 探讨大鼠异体肢体移植术后急性排斥反应阶段移植肢体血管内皮细胞损伤的病理形态学特征,凋亡及其意义.方法建立封闭群大鼠同基因组(Wistar→Wistar)(A组)和异基因组(SD→Wistar)(B组)肢体移植动物模型,异体肢体移植术后1、3、5、7、9 d,运用流式细胞仪测试外周血T淋巴细胞亚群动态变化;术后第1、4、7 d切取发生急性排斥反应肢体的股动、静脉1.0cm标本,行HE染色,光镜观察;原位末端标记(TUNEL)法检测移植肢体血管内皮细胞凋亡阳性细胞数.结果术后3 d外周血CD4+增加显著,CD8+增加不明显,CD4+/CD8+比值明显升高,与术前和术后1 d比较差异有统计学意义(P＜0.01),术后5至9 d,CD4+/CD8+比值仍维持较高水平.血管HE染色提示内皮层在移植术后4 d出现内膜细胞连续性中断,EC表面不光滑,移植术后7 d,动脉各层有多量的淋巴细胞浸润,内膜层偶见梭形核细胞.异体移植术后1 d,4 d,7 d血管内皮细胞凋亡数分别为[(12.25±7.24)个,x±s,下同],(41.13±8.53)个,(80.56±21.69)个.结论异体肢体移植术后急性排斥反应阶段,血管内皮细胞凋亡活性明显增高,提示细胞凋亡是大鼠肢体移植急性排斥反应期血管内皮细胞免疫损伤的主要原因之一。
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