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对155例移植肾标本进行了组织学、免疫荧光及免疫组化研究,其中超急性排斥27例,急性排斥74例,慢性排斥54例。超急性排斥反应早期以肾间质小血管及肾小球毛细血管内大量红细胞淤滞为主要改变。急性排斥反应的变化为:①间质水肿、充血、出血,淋巴细胞、单核细胞浸润;②动脉内膜炎、全层炎及血管壁纤维样坏死;③肾小管上皮浊肿、变性、坏死。慢性排斥反应的移植肾的病理改变主要以增殖性改变为特征。研究认为红细胞也可能参与超急性排斥反应。由于红、白细胞的双重作用,而加速了超排的损伤。急性排斥反应病变的程度和肾移植的时间并不成正相关,所以作者根据病变的程度和临床工作的需要,将其病理学改变分为轻、中、重三级。在此基础上提出临床治疗的方案。
The histological, immunofluorescence and immunohistochemical studies of 155 renal allograft samples were performed, including 27 cases of hyperacute rejection, 74 cases of acute rejection and 54 cases of chronic rejection. Hyperacute rejection in early renal interstitial small blood vessels and glomerular capillary large number of red blood cell stasis as the main change. Acute rejection changes: interstitial edema, congestion, bleeding, lymphocytes, monocyte infiltration; endarteritis, full-thickness inflammation and fibrovascular necrosis; tubular epithelial swelling, degeneration and necrosis . Pathological changes in chronic rejection of transplant kidneys are primarily characterized by proliferative changes. Studies suggest that red blood cells may also participate in hyperacute rejection. Due to the dual role of red and white blood cells, while accelerating the superovulation damage. The extent of acute rejection and renal transplantation time is not a positive correlation, so the author according to the extent of the lesion and clinical needs, the pathological changes are divided into light, moderate and heavy levels. On this basis, the clinical treatment program.