大鼠移植小肠急性排斥反应期组织病理学研究

A study of histopathological changes of small bowel allograft during acute rejection in rats

目的 探讨大鼠异位小肠移植急性排斥反应期移植小肠病理学特点及意义。方法 实验分 4组 ,每组 6只。A组为非手术对照组 ;B组为异系移植组 ;C组为同系移植组 ;D组为异系移植加环孢霉素A治疗组。术后 3 ,5 ,7,10d取移植小肠进行病理学检查 ,测量黏膜厚度 ,绒毛高度和隐窝深度 ;并检测 3 ,5 ,7d移植小肠黏膜细胞凋亡。结果 A组小肠黏膜正常 ;B组移植小肠炎性细胞浸润、黏膜结构破坏程度和黏膜细胞凋亡数目明显高于C ,D组 ,随移植时间的延长黏膜细胞凋亡数目增加 ,黏膜结构破坏程度加重 ;C组移植小肠黏膜结构损伤程度较B组轻 ;D组仅有少量炎性细胞浸润 ,间质轻度水肿 ,未见黏膜结构破坏。结论 炎性细胞浸润、黏膜细胞凋亡和黏膜结构破坏是移植小肠急性排斥反应损伤病理学变化的主要特点。动态观察移植小肠病理学变化和细胞凋亡 ,对诊断小肠移植急性排斥反应和估计损伤程度有一定的价值。

Objective To investigate the features and significance of pathologic changes in apoptosis of small bowel allograft during acute rejection in rats. Methods All 24 recipients were equally divided into four groups ; group A: nonoperative control; group B: allograft ; group C: isograft, group D: treatment control. The graft samples were harvested on day 3, 5, 7, 10 after transplantation, and subjected to histologic examination . Mucosal thickness, villous height and crypt depth were measured, and apoptotic cells of intestinal mucosa of grafts on day 3,5 and 7 after transplantation were examined. Results The mucosal structure was normal in group A; The degree of the inflammatory infiltrated cells ,intestinal mucosa cell apoptosis and structural injury of mucosa in group B were significantly severe compared with groups C and D. As the post-transplanted time increased, the number of musocal apoptotic cells and the degree of mucosal structural injury were significantly increased. The degree of mucosal structural injury in group C was milder than in group B. A few infiltrated cells and mild edema of mucosa occurred in group D , but no mucosal structural injury was found. Conclusions Inflammatory cell infiltration, mucosal epithelial cell apoptosis and mucosal structural damage are the main pathologic features of small bowel allograft during acute rejection. Dynamic observation of the pathologic changes and cell apoptosis of small bowel graft is of certain value in the diagnosis of acute rejection of small bowel graft and in assessment of the degree of small bowel injury.