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目的 研究大鼠同种异体心脏移植模型中细胞间粘附分子－１（ＩＣＡ－１）的表达以及环抱嘌呤Ａ（ＣｓＡ）抗免疫排斥的作用，井探讨该作用的影响因素。方法 根据国际心肺移植组织（ＩＳＨＬＴ）１９９０年心脏急性排异反应分级标准．对心脏移植大鼠进行排异反应分析；用免疫组织化学方法检测ＩＣＡＭ－ｌ的表达部位和表达水平。结果 心脏移植后，供者心脏和主动脉标本中，１ｄ和 ３ｄ时出现轻度炎性浸润，排异反应为 １Ａ或 １Ｂ级；１１ｄ和 １２ｄ时可出现弥谩性炎性浸润和心肌坏死，并伴明显水肿、出血以及血管炎．排斥级别达３Ｂ或４级。ＣＳＡ治疗可使心脏移植排异降低１～２．５级。移植后血管内皮细胞、外膜浸润淋巴细胞的ＩＣＡＭ－１表达显著升高。ＣｓＡ治疗可明显抑制供者心脏及主动脉的ＩＣＡＭ－１表达。该抑制作用在ｌ～３ｄ内，呈ＣｓＡ剂量依赖性．而在７～１１ｄ内无剂量差异。结论ＣｓＡ治疗是下凋淋巴细胞迁移和浸润、减弱移植排斥反应的有效手段．其机理可能与降低粘附分子表达有关。
Objective To investigate the expression of intercellular adhesion molecule-1 (ICA-1) in rat heart allograft and the anti-rejection effect of cyclosporin A (CsA), and to explore the influencing factors of this effect. Methods According to the International Heart Lung Transplantation Organization (ISHLT) 1990 acute rejection classification standard. The rejection of heart transplantation rats was analyzed. The expression of ICAM-1 was detected by immunohistochemistry. Results After the heart transplantation, the donor heart and aortic specimens showed mild inflammatory infiltration on day 1 and 3, with rejection of 1A or 1B. Mild inflammatory infiltration and myocardial necrosis occurred on day 11 and 12, With significant edema, bleeding and vasculitis. Exclusion level of 3B or 4. CSA treatment can reduce the rejection of heart transplantation 1 to 2.5. After transplantation, the expression of ICAM-1 in vascular endothelial cells and adventitial infiltrating lymphocytes was significantly increased. CsA treatment significantly inhibited ICAM-1 expression in donor heart and aorta. The inhibition in l ~ 3d, CsA dose-dependent manner. In 7 ~ 11d no dose difference. Conclusion CsA treatment is an effective means to down-regulate the migration and infiltration of lymphocytes and attenuate graft rejection. The mechanism may be related to reducing the expression of adhesion molecules.