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目的探讨补体裂解片断C4d在监测大鼠肾移植后慢性排斥反应中的作用与意义。方法以封闭群Wistar大鼠为供者,SD大鼠为受者,建立大鼠肾移植模型。将42只受者随机平均分为2组,A组在肾移植术后10d内给予小剂量环孢素A(5mg·kg-1·d-1)治疗;B组除使用环孢素A外,另给予霉酚酸酯10mg·kg-1·d-1灌胃。术后第3、5和10周观察各组移植肾形态变化及移植肾组织中C4d沉积情况。结果从术后第3周起,A组开始出现轻微慢性排斥反应的病理改变,并随着时间的推移逐渐明显。B组于术后第5周开始出现慢性排斥反应的病理改变,程度轻于A组。术后第3周A组即出现明显C4d沉积,至第10周时沉积已较广泛。B组也有C4d沉积,但沉积程度较A组同时段轻(P<0.05)。结论移植肾组织中C4d的沉积早于慢性排斥反应的病理改变,可作为预测慢性排斥反应的有效指标。
Objective To investigate the role and significance of C4d in the detection of chronic rejection after kidney transplantation in rats. Methods The Wistar rats were used as donors and SD rats as recipients to establish a rat renal transplantation model. Forty-two recipients were randomly divided into two groups. Group A received low-dose cyclosporine A (5 mg · kg-1 · d-1) within 10 days after renal transplantation. In group B, cyclosporine A , And the other given mycophenolate 10mg · kg-1 · d-1 gavage. At 3, 5 and 10 weeks after operation, morphological changes of allograft kidneys and C4d deposition in renal allografts were observed. Results From the third week after operation, pathological changes of mild chronic rejection began to appear in group A, and gradually became obvious with the passage of time. The pathological changes of chronic rejection began to occur in group B at 5 weeks after operation, to a lesser extent than in group A. In the third week after operation, obvious C4d deposition appeared in group A, and deposition was broader at the tenth week. Group B also had C4d deposition, but its deposition was lighter than that of group A in the same period (P <0.05). Conclusion The deposition of C4d in renal allografts was earlier than the pathological changes of chronic rejection and could be used as an effective indicator for predicting chronic rejection.