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目的探讨淋巴淤滞对自体肾移植的影响。方法选择家兔为实验对象,左侧肾脏用于自体肾移植模型和淋巴瘀滞模型的建立,右侧肾脏用于自体肾移植模型的建立,以做对照。分别于术后第4、7、14、28天处死实验兔。分别从淋巴淤滞肾和对照肾切取标本,用40 g/L甲醛固定,石蜡包埋切片,HE染色。结果淋巴淤滞肾(左肾)周围组织明显水肿、粘连,随着术后时间的延长,水肿减轻但粘连加重。两侧肾的肾小球和肾小管未见明显变化。术后第4天时,淋巴淤滞肾的小叶间毛细淋巴管扩张明显,淋巴液淤积,间质呈多灶性淋巴细胞浸润并伴有水肿;术后第7天时,除上述变化外,肾间质淋巴细胞浸润及水肿最明显;术后第14天时,小叶间毛细淋巴管萎缩,间质呈少量淋巴细胞浸润;术后第28天时,毛细淋巴管明显萎缩,并伴有肾小球毛细血管充血。结论淋巴淤滞对自体移植肾的组织学有一定影响,并可能是加重肾移植后急、慢性排斥反应发生的重要因素。
Objective To investigate the effect of lymphatic stasis on autologous kidney transplantation. Methods Rabbits were selected as the experimental subjects. The left kidney was used to establish the model of autologous kidney transplantation and lymphatic stasis. The right kidney was used to establish the model of autologous kidney transplantation. Experimental rabbits were killed on the 4th, 7th, 14th and 28th day respectively. The specimens were harvested from the lymphatic stasis kidney and the control kidney, fixed with 40 g / L formalin, embedded in paraffin and stained with HE. Results The lymphatic stasis of renal (left kidney) tissue around the obvious edema, adhesions, with the extension of postoperative time, edema reduced but the adhesion increased. Nephrotic glomeruli and tubules on both sides showed no significant changes. On the 4th day after operation, lymphatic stasis showed obvious dilatation of lymphatic capillaries between the interlobular lobes, lymphatic fluid deposition and interstitial multifocal lymphocyte infiltration accompanied with edema. On the 7th day after operation, in addition to the above changes, Lymphocyte infiltration and edema were the most obvious. On the 14th day after operation, there was atrophy of capillary lymphatic vessels between the interlobular lobes and a small amount of lymphocytic infiltration in the interstitium. On the 28th day after operation, the lymphatic capillaries were significantly atrophic accompanied with glomerular capillary congestion . Conclusion Lymphatic stasis has some effects on the histology of autologous grafts and may be an important factor to aggravate acute and chronic rejection after renal transplantation.