移植动脉慢性排斥反应的病理组织学观察

Pathohistological observation of the transplant arteriosclerosis of chronic rejection

目的 了解慢性排斥反应时移植物动脉硬化的病理变化。方法 采用病理图象定量分析及电镜等检测手段 ,观察大鼠动脉移植后 3、7、14、2 0、30及 6 0d的病理变化。结果 同系移植对照组除供者血管冷缺血超过 1h的 2只术后 14d内膜轻度增生外 ,其余移植动脉与受者自身的正常动脉比较 ,差异不显著 ;异系移植实验组术后 3d血管外膜有大量炎性细胞浸润 ,7d时局部内皮剥脱 ,14d内膜中层细胞通过弹力膜裂隙向内膜迁移 ,内膜增生 ,2 0d内膜全层或局部呈半月形增生 ,平滑肌细胞形态由收缩型转变为合成型 ,30d内膜细胞数达峰值 ,6 0d内膜持续增厚 ,基质纤维成分增多 ,内膜修复。结论 移植体动脉硬化具有内皮剥脱、炎性细胞浸润、中层坏死、平滑肌细胞迁移及内膜增生

Objective To investigate the pathohistological changes of transplant arteriosclerosis in chronic rejection. Methods Pathological change of transplant aorta was observed by using the computer image analysis system and electron microscopy at 3, 7, 14, 20, 30 and 60 days after arterial transplantation. Results Except two grafts in which the cold ischemia time of donor aorta exceeded 1?h showed minimal intimal thickening at 14 days in the control group post operation, the remaining transplant arteries showed no significant difference from the normal arteries of the recipients themselves. In the allografts group, the inflammatory cells infiltrated in the adventitia at the third day post operation, intimal denudation at 7th day, the cell migrated from media to intima and the intimal hyperplasia at the 14th day, and the intimal mid semimonth hyperplasia at the 20th day. The smooth muscle cell was transformed from contractile type into synthetic type and the cell numbers reached peak at the 30th day. At the 60th day, the intimal hyperplasia developed persistently, the stroma fibrocyte was increased and the endothelium recovered. Conclusions The transplant arteries were characterized by intimal denudation, inflammatory cell infiltration, media necrosis with the smooth muscle cell migration and intimal hyperplasia.