猫胰十二指肠移植的组织病理学研究

Histopathological changes in pancreaticoduodenal allotransplantation in cat

为研究全胰、十二指肠移植早期自然的排斥反应和应用抗排斥药物后胰、十二指肠移植物的组织病理学变化，对２７只猫施行了全胰、十二指肠移植术。实验分为对照组（Ａ组）、地塞米松组（Ｂ组）、环孢素Ａ１（ＣｓＡ）组（Ｃ组）及ＣｓＡ２组（Ｄ组），在动物死亡时立即切取移植胰做病理检查。结果对照组平均存活６．１天，移植胰腺全部发生坏死，十二指肠粘膜及肠壁亦明显坏死。地塞米松组动物平均存活１８．４天，死亡时移植胰腺和十二指肠呈现程度不等的坏死和急、慢性炎症，小叶间质出现纤维组织增生。Ｃ组每天经口给予ＣｓＡ２０ｍｇ／ｋｇ，动物平均存活时间为１０天，移植胰腺可见程度不等的部分坏死，轻者接近正常，十二指肠基本正常。Ｄ组每天经口给予ＣｓＡ１０ｍｇ／ｋｇ，动物平均存活时间为３１天，移植胰腺组织结构良好，仅部分腺泡萎缩，轻度纤维组织增生，间质有散在淋巴细胞浸润，十二指肠粘膜有慢性炎症反应。研究提示移植胰腺在急性排斥时全部发生坏死，十二指肠粘膜及肠壁也同时发生坏死；免疫抑制剂的抗排斥作用可减轻移植胰腺的损伤，延长移植动物的存活时间，但对肝和肾的毒性损害应注意。

Twenty-seven cats receiving the pancreaticoduodenal allotransplantation were divided into four groups. Seven cats in group A had no any immunosuppression treatment with the survival time being 6.1 days; eight cats in group B received injection of 2mg/day dexamethasone with the survival time being 18.4 days. The transplanted pancreas and duodenum were found having necrosis, acute and chronic inflammation in varying degrees. The 8 cats in group C orally administrated cyclosporine A (CsA) with 20mg·kg-1/day with the survival time being only 10 days, the necrosis of the allografts is not so severe, but the damage of the liver and the kidney can be found by the microscopic examination. When the dosage of CsA was reduced from 20mg·kg-1/day to 10mg·kg-1/day, 4 cats in group D survived relatively longer with the survival time being 31 days, the longest being 50 days, which showed a significant difference with any other group (P<0.01). No marked necrosis was found in all allografts in group D. Mild damage of the liver and kidney demonstrated the toxic effects of CsA.