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目的观察腹腔注射骨化三醇对肾移植大鼠存活的影响。方法以SD大鼠为供体,Wister大鼠为受体,建立大鼠肾移植模型。受鼠随机分为4组:对照组;环孢素A(CyclosporineA,CsA)组采用CsA 3 mg·kg~(-1)·d~(-1)肌肉注射,术后连续给药13 d;骨化三醇组采用骨化三醇1μg·kg~(-1)·d~(-1)腹腔注射,术后连续给药13 d;CsA+骨化三醇组按骨化三醇组和CsA组用药剂量给药。观察4组受鼠移植肾生存时间,并于术前4 d,术后6 d、15 d检测血肌酐以及术后第10 d用MTT法检测受鼠脾细胞对供鼠抗原刺激的混合淋巴细胞反应,同时进行移植肾病理学检查,按照Banff Schema标准诊断急性排斥反应,并根据Watanabe的方法进行排斥反应严重程度半定量评分。结果 CsA组、骨化三醇组、CsA+骨化三醇组受鼠移植肾生存时间分别为(16.5±2.7)d、(13.3±3.2)d和(24.8±2.6)d,较对照组(8.7±1.8)d明显延长(P<0.01);3组移植后6 d血肌酐浓度分别为(67.4±8.0)mmol/L、(62.7±7.5)mmol/L、(77.1±9.4)mmol/L,明显低于对照组(424.3±61.2)mmol/L(P<0.01);术后10 d 3组混合淋巴细胞检测结果也明显低于对照组(P<0.01);同时3组移植肾病理检查的半定量评分结果也明显低于对照组(P<0.05)。结论骨化三醇能抑制肾移植受鼠急性排斥反应,骨化三醇与CsA联合应用可以改善肾功能,延长移植肾的生存时间。
Objective To observe the effects of intraperitoneal injection of calcitriol on the survival of renal allograft rats. Methods SD rats were used as donors and Wister rats as recipients to establish rat kidney transplantation model. The rats were randomly divided into 4 groups: the control group; cyclosporin A (CsA) group was injected intramuscularly with CsA 3 mg · kg -1 (-1) d -1 for 13 days; The calcitriol group was injected intraperitoneally with 1 μg · kg -1 d -1 of calcitriol for 13 days. The CsA + calcitriol group was treated with calcitriol and CsA Group administration dose. The survival time of renal allograft in 4 groups was observed. Serum creatinine was detected at 4 days before operation, 6 days and 15 days after operation, and mixed lymphocytes stimulated by mouse antigens were detected by MTT assay Response, along with a nephrological examination of the grafts, diagnosis of acute rejection according to the Banff Schema criteria, and semi-quantitative rejection severity according to Watanabe’s method. Results The survival time of renal allograft in CsA, calcitriol and CsA + calcitriol groups was (16.5 ± 2.7) d, (13.3 ± 3.2) d and (24.8 ± 2.6) d respectively, which was significantly higher than that in control group (8.7 ± 1.8) d (P <0.01). Serum creatinine concentrations at 6 d after transplantation were (67.4 ± 8.0) mmol / L, (62.7 ± 7.5) mmol / L and (77.1 ± 9.4) mmol / L, (424.3 ± 61.2) mmol / L (P <0.01), and the results of mixed lymphocyte test in group 3 at 10 days after operation were also significantly lower than those in control group (P <0.01). At the same time, Semiquantitative score was also significantly lower than the control group (P <0.05). Conclusion Calcitriol can inhibit renal allograft rejection in rats. Calcitriol combined with CsA can improve renal function and prolong the survival time of renal allograft.