犬同种带瓣大动脉移植后的免疫学研究  

Immunology of conduit valved homograft implantation in dog

作　　者：于建华[1] 张供[1] 陈艰[1] 谷兴华[1] 郭宏伟[1] 许复郁[1] 李守先[1] 

机构地区：[1]山东大学齐鲁医院心外科,山东济南250012

出　　处：《山东大学学报（医学版）》2005年第8期719-722,726,共5页Journal of Shandong University:Health Sciences

基　　金：山东省卫生厅资助课题(2001CA2CGA1)。

摘　　要：目的:检测同种带瓣大动脉(conduitvalvedhomograft,CVH)移植后的免疫反应,探讨其作用机制及临床意义。方法:①建立液氮冻存和4℃保存犬CVH(各14例)移植于异性受体犬腹主动脉实验模型;②在移植术后不同时点切取植入的CVH标本;免疫组织化学染色法检测细胞免疫及体液免疫反应,用光镜、扫描电镜及透射电镜进行观察。结果:术后7d即可出现细胞免疫反应;1￣3月达高峰;6￣12月呈持续的低水平状态;表现为CVH内膜、动脉外膜、瓣下心肌组织中T细胞(以CD8+细胞和CD4+细胞为主)浸润,IL-2Ra持续表达。体液免疫反应仅发生于术后7d￣3个月,IgG沉积于CVH内膜和动脉中层平滑肌细胞周围;CVH瓣下心肌细胞、动脉中层平滑肌细胞间有散在的CD21+细胞浸润。结论:①CVH具有免疫原性。内皮细胞、平滑肌细胞、心肌细胞是其免疫原性表达的主要部分;②CVH移植术后早期(3个月以内)行免疫排斥反应的监测及防治具有临床意义。Objective： To study the immunoreaction and its clinical significance after conduit valved homograft （CVH） implanting in dog. Methods：①Canine CVH stored at 4℃（n=14） or cryopreserved in liquid nitrogen at -196℃ （n=14） was heterotopic transplanted in the abdominal aorta of the recipient dog whose sexuality was different from the donor;②specimens of CVH were collected at different time points after transplantation and detected the specific cellular immune responses and humoral immune responses by immunohistochemical staining method, histology and uhrastructure examination. Results： Cellular immune responses, infihrated of endometrium of CVH, tunica adventitia of artery and myocardium tissue of infra-valve, T cells （CD8^＋and CD4^＋） and last expressed of IL-2Ra , emerged at 7 days postoperation , rose to the peak in 1 to 3 months postoperation, and reduced gradually to a continuous low level in 6 to 12 months postoperation. Humoral immune responses, IgG deposited on endometrium of CVH and smooth reusable cell of artery, CD21^＋ cell infiltrated in myocardium tissue of infra-valve and smooth muscle cell of artery, only occured in 7 days to 3 months postoperation. Conclusion： ①CVH has immunogenicity. The endothelial cells, smooth muscle cells and myocardial cells are the main parts of the CVH tissues to express immunogenicity; ②the surveillance of immune rejection has an important clinial significance in the early duration （within 3 months） after CVH implantation.

关 键 词：免疫测定 超微结构 心脏瓣膜 移植 同种 狗 

分 类 号：R654.2[医药卫生—外科学]