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目的 探讨肾移植急性排斥期肾小管上皮细胞凋亡与移植排斥的关系。 方法 选用近交系DA大鼠 ,LEW大鼠进行原位左肾移植。实验组 :异基因移植组 (DA→LEW ) ,对照组 :同基因移植组 (LEW→LEW)。于手术后第 2、4、6天分别取移植肾进行病理学检查及电镜扫描 ,采用TdT介导的脱氧核苷酸原位末端标记法 (TUNEL)检测移植肾脏中的凋亡细胞及血清肌酐水平。 结果 病理学检查结果显示实验组大鼠在术后第 2、4、6天分别发生轻、中、重度排斥 ,对照组无明显排斥现象。TUNEL法结果显示实验组于手术后第 2、4、6天细胞凋亡数明显高于对照组 (P <0 .0 1) ,手术后第 4天差异最大 ,术后第 6天因严重排斥而使肾小管上皮细胞坏死脱落。肾小管上皮细胞凋亡程度与血清肌酐水平、病理学检查结果一致。 结论 肾小管上皮细胞凋亡在大鼠异基因肾脏移植急性排斥反应中发挥重要作用。
Objective To investigate the relationship between renal allograft apoptosis and renal allograft rejection after renal transplantation. Methods In-line DA rats and LEW rats were selected for in situ left kidney transplantation. Experimental group: allogeneic transplantation group (DA → LEW), control group: same gene transplantation group (LEW → LEW). On the 2nd, 4th, and 6th day after operation, the grafted kidneys were harvested for pathological examination and electron microscopy. TUNEL was used to detect apoptotic cells and serum creatinine in the transplanted kidneys by TdT-mediated dUTP nick end labeling (TUNEL) Level. Results The results of pathological examination showed that mild, moderate and severe rejection occurred on the 2nd, 4th, 6th day in the experimental group, while the control group showed no obvious rejection. The results of TUNEL showed that the number of apoptotic cells in experimental group was significantly higher than that in control group on the 2nd, 4th and 6th day after operation (P <0.01). The difference was greatest on the 4th day after operation, Leaving tubular necrosis of epithelial cells off. Tubular epithelial cell apoptosis and serum creatinine levels, the same pathological findings. Conclusion Apoptosis of renal tubular epithelial cells plays an important role in acute allograft rejection in rats.