本文選題：肝移植 + 恒河猴　； 參考：《中國(guó)組織工程研究》2014年49期

【摘要】：背景:尋找肝移植急性排斥反應(yīng)的早期診斷指標(biāo),可快速而有效的評(píng)估移植后排斥反應(yīng)的風(fēng)險(xiǎn),而T淋巴細(xì)胞在急性排斥反應(yīng)中發(fā)揮主要作用。目的:觀察恒河猴肝移植后血液T淋巴細(xì)胞亞群的變化與急性排斥反應(yīng)的關(guān)系。方法:采用改良血管袖套+膽道支撐管+動(dòng)脈吻合法建立16例穩(wěn)定的恒河猴肝移植模型,并將模型隨機(jī)分為2組:實(shí)驗(yàn)組圍手術(shù)期不給予免疫抑制治療,對(duì)照組圍手術(shù)期給予免疫抑制治療,分別在移植后6,12,24,72 h共4個(gè)時(shí)間點(diǎn)收集血標(biāo)本和肝組織,全自動(dòng)生化分析儀測(cè)定丙氨酸氨基轉(zhuǎn)移酶、天冬氨酸氨基轉(zhuǎn)移酶、總膽紅素,用流式細(xì)胞儀檢測(cè)血CD4+/CD8+水平,然后取移植后肝臟組織進(jìn)行蘇木精-伊紅染色以觀察肝臟組織形態(tài)結(jié)構(gòu)的改變,并根據(jù)Banff評(píng)分系統(tǒng)判斷排斥反應(yīng)程度。結(jié)果與結(jié)論:實(shí)驗(yàn)組恒河猴肝移植后12,24,72 h均有急性排斥反應(yīng)發(fā)生,其中實(shí)驗(yàn)組丙氨酸氨基轉(zhuǎn)移酶、天冬氨酸氨基轉(zhuǎn)移酶和總膽紅素在移植后24,72 h表達(dá)水平明顯高于對(duì)照組(P0.05),實(shí)驗(yàn)組和對(duì)照組CD4+/CD8+的表達(dá)在移植后6 h即開(kāi)始增高,實(shí)驗(yàn)組增高最明顯,實(shí)驗(yàn)組移植后24,72 h CD4+/CD8+的表達(dá)明顯高于對(duì)照組(P0.05),實(shí)驗(yàn)組移植后72 h肝臟組織形態(tài)病理改變程度重于對(duì)照組,Banff評(píng)分高于對(duì)照組(P0.05)。說(shuō)明在肝移植后急性排斥反應(yīng)早期,CD4+/CD8+的表達(dá)變化早于肝組織病理學(xué)及肝功能的改變。肝移植后血CD4+/CD8+水平的升高提示人體細(xì)胞免疫功能增強(qiáng),對(duì)肝移植后急性排斥反應(yīng)的早期診斷具重要意義。
[Abstract]:Background: looking for early diagnostic indicators of acute rejection in liver transplantation can quickly and effectively assess the risk of rejection after transplantation, and T lymphocytes play a major role in acute rejection. Aim: to observe the relationship between the changes of blood T lymphocyte subsets and acute rejection in rhesus monkey after liver transplantation. Methods: 16 stable rhesus monkey liver transplantation models were established by modified vascular cuff with bile duct arterial anastomosis. The models were randomly divided into two groups: the experimental group was not treated with immunosuppressive therapy during perioperative period. The control group was treated with immunosuppressive therapy during perioperative period. Blood samples and liver tissues were collected at 6: 12 ~ 2472 h after transplantation. The levels of alanine aminotransferase, aspartate aminotransferase and total bilirubin were measured by automatic biochemical analyzer. The level of CD4 / CD8 was detected by flow cytometry, and then the liver tissue was stained with hematoxylin and eosin to observe the changes of liver morphologic structure. The degree of rejection was judged according to the Banff score system. Results and conclusion: acute rejection occurred in the experimental group after liver transplantation in rhesus monkeys, and alanine aminotransferase was found in the experimental group. The expression of aspartate aminotransferase and total bilirubin was significantly higher than that of control group at 24 ~ 72 h after transplantation. The expression of CD4 / CD8 in experimental group and control group began to increase 6 hours after transplantation. The expression of CD4 / CD8 in the experimental group was significantly higher than that in the control group at 24 ~ 72 h after transplantation, and the degree of histopathological changes of liver in the experimental group was more serious than that in the control group at 72 h after transplantation. The results showed that the expression of CD4 / CD8 was earlier than that of liver histopathology and liver function in the early stage of acute rejection after liver transplantation. The increase of serum CD4 / CD8 level after liver transplantation indicates that the enhancement of human cellular immune function is of great significance for the early diagnosis of acute rejection after liver transplantation.
【作者單位】： 昆明醫(yī)科大學(xué)附屬甘美醫(yī)院肝膽胰外科 云南省器官移植研究所肝移植研究中心;
【基金】：the Major Program of Kunming Science and Technology Bureau,No.08S100304~~
【分類(lèi)號(hào)】：R657.3;R-332
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本文編號(hào)：1824614