C4d在肝移植排斥反应中表达的意义  

Signification of CAd deposition in liver rejection

作　　者：卜宪敏[1] 郑智勇[1] 余英豪[1] 曾玲[1] 江艺[2] 

机构地区：[1]福州总医院病理科 [2]福州总医院院肝胆外科

出　　处：《福州总医院学报》2008年第B12期359-360,共2页Journal of Fuzhou General Hospital

摘　　要：目的:研究肝移植排斥反应中C4d沉积的部位和意义。方法:对肝移植患者的肝穿刺标本作C4d免疫组化染色,观察C4d阳性沉积情况与肝脏病理改变的关系。结果:急性细胞性排斥反应中的69.2%肝移植标本,在肝小叶汇管区小血管壁及肝血窦壁上有C4d的沉积,33.3%移植后乙肝复发和28.6%乙型肝炎的标本中,仅汇管区小血管壁有C4d的沉积,而无肝血窦壁上C4d的沉积.12倒器官保存性损伤的肝标本中1例汇管区小血管壁及肝血窦壁上有C4d的沉积,此例1mo后再次穿刺发现急性细胞性排异反应.肝移植后胆管阻塞的标本中没有发现C4d的沉积。结论:结论:C4d在肝血窦壁的沉积可以作为肝移植急性排斥反应鉴别诊断一个比较特异的免疫组化指标。Objective： AIM： To investigate the position and significance of CAd deposition in the specimens of liver rejection. Method： CAd immunohistological staining for the liver allografts biopsies, observing the relation between CAd deposkion and pathological alteration of liver. Results： CAd expression in the samples of liver cellular rejection was 69.2 %, 33.3 % in hepatitis B relapse after transplantation and 28.6 % in hepatitis B. In the biopsies of liver rejection, CAd deposited in the vascular wails of portal areas and hepatic sinusoidal walls. In the biopsies of hepatitis B relapse after transplantation and hepatitis B ordy deposited in the vascular walls of portal area. In the biopsies of ischemia reperfusion damage, CAd deposited in the vascular walls of portal areas and hepatic sinusoidal wall was detected in 1 of 12 patients, and follow - up biopsy after 1 month revealed acute cellular rejection. No CAd deposited in bile duct occlusion after liver transplantation. Conclusion： CAd might be served as a sensitive marker in diagnosing liver rejection.

关 键 词：肝移植排斥反应 C4D 急性细胞性排斥反应 肝移植急性排斥反应 穿刺标本 免疫组化染色 肝脏病理改变 免疫组化指标 

分 类 号：R657.3[医药卫生—外科学] R699.2[医药卫生—临床医学]