慢性排斥肾肥大细胞形态与超微结构的研究

The morphological and ultrastructural studies on mast cells in chronic rejection of kidney allograft

目的： 了解肾移植慢性排斥反应时肥大细胞在排斥肾中的形态、超微结构特点及分布规律，以探讨肥大细胞是否在肾移植慢性排斥反应中所起的作用。方法：采用甲苯胺蓝、爱尔沙蓝特殊染色法及电子显微镜技术。结果：发现慢性排斥肾中， 有较多的肥大细胞， 主要分布于肾皮质区。特殊染色及超微结构的结果显示，排斥肾中至少存在幼稚与成熟两种类型的肥大细胞。在移植后３ 个时间段（ ＜ １ 年， １ 年～４ 年及＞ ４ 年） ，每个高倍视野中，肥大细胞的平均数分别为２ ．０９ ±２ ．８４ ，８ ．９３ ±４ ．２５ 和１３ ．７６ ±４ ．５３ ，随着移植时间的延长，肥大细胞呈增加的趋势。４ 年以上组明显高于１ 年～４ 年组，（ Ｐ ＜ ０ ．０１） ；小于１ 年组的病例中５２ ％ 未见到肥大细胞。结论：肥大细胞可能参与了肾移植慢性排斥反应，其作用机理尚需进一步研究。

Aim:To clarify the morphological and ultrastructural features and the regularity of distribution of mast cells in the transplanted kidneys of chronic rejection and to srudy if mast cells play a role in the chronic rejection of kidney transplantation. Methods: Special stainings of toluidine blue, Alcian blue and electron microscopic technique were used in the study. Results: There were more mast cells in the kidneys of chronic rejection and the cells were mainly distributed in the cortex region of the rejected kidneys. Special stainings and ultrastructural study showed that there were at least two types of mast cells, the young and the mature, in the rejected kidneys. In the groups of < 1 year, 1～4 year, and > 4 year after transplantation, the means of counted mast cells in each high power field were 2.09±2.84, 8.93±4.25 and 13.76±4.53, respectively. The numbers of mast cells were increased with the lengthening of survival time of the grafts. This parameter in the group of > 4 year was significantly higher than that in the group of 1～4 year(P < 0.01). Mast cells were not seen in 52%of kidneys in the group of < 1 year. Conclusion: Mast cells may be involved in the chronic rejection of kidney transplantation and its mechanism remains to be studied.