移植心脏动脉硬化和心肌细胞坏死的研究

Cardiac allograft arteriosclerosis and myocardial necrosis

目的 探讨心肌细胞坏死、纤维化和动脉硬化在移植心脏中的发生和发展情况 ,为心脏移植的抗排斥反应治疗和预防提供依据。 方法 用供体脾细胞 (SPC)和环磷酰胺 (CP)预处理移植受体 ,然后行异位心脏移植术 ,HE、Masson、VanGieson染色对移植心脏的炎细胞浸润、心肌细胞坏死、心肌纤维化和冠状动脉硬化进行分析。 结果 SPC和CP预处理后 ,移植心脏的存活时间明显延长 ,炎细胞浸润、心肌细胞坏死、心肌纤维化和冠状动脉硬化明显减轻。 结论 (1)大鼠心脏移植的急性排斥反应是由心外膜周围起始逐渐向心内膜方向发展。 (2 )胶原纤维在血管壁内的广泛浸润是引起冠状动脉向心性狭窄的原因之一。 (3)SPC和CP联合预处理 。

Objective To study the development of myocardial necrosis,fibrosis, and arteriosclerosis in cardiac allograft in order to provide a theoretical basis for the prevention and treatment of anti rejection. [MethodsThe recipient was pretreated with inoculation of donor splenocytes (SPC) followed by cyclophosphamide(CP). Heterotopic cervical heart transplantation was performed. The allografts stained with Hematoxylin and eosin(HE), Masson and Van Gieson were studied about inflammatory cell infiltration, myocardial necrosis, fibrosis and arteriosclerosis. Results Preconditioning with SPC followed by CP prolonged the survival time of cardiac allograft. Inflammatory cell infiltration, myocardial necrosis, fibrosis, and arteriosclerosis in cardiac allograft were significantly decreased. ConclusionsThe development of acute cardiac allograft rejection originated from the epicardial area to the intimal area of the heart in rat. The infiltration of collagenous fiber in the coronary arteries is one of the major causes of concentric stenosis. The pretreatment of SPC followed by CP can prevent and relieve the rejection.