摘要
对１５５例移植肾标本进行了组织学、免疫荧光及免疫组化研究，其中超急性排斥２７例，急性排斥７４例，慢性排斥５４例。超急性排斥反应早期以肾间质小血管及肾小球毛细血管内大量红细胞淤滞为主要改变。急性排斥反应的变化为：①间质水肿、充血、出血，淋巴细胞、单核细胞浸润；②动脉内膜炎、全层炎及血管壁纤维样坏死；③肾小管上皮浊肿、变性、坏死。慢性排斥反应的移植肾的病理改变主要以增殖性改变为特征。研究认为红细胞也可能参与超急性排斥反应。由于红、白细胞的双重作用，而加速了超排的损伤。急性排斥反应病变的程度和肾移植的时间并不成正相关，所以作者根据病变的程度和临床工作的需要，将其病理学改变分为轻、中、重三级。在此基础上提出临床治疗的方案。
cases of the renal graft (hyperacute rejection 27 cases,acute rejection 74 cases, chronic rejection 54 cases)were studied by light microscopy, histochemistry and immuno histochemistry. Result showed that:1. A large number of the red blood cells lay and stagnated instead of circulation in the little blood vessels of renal interstitial and the blood capillary of glomeruli during the early stage of hyperacute rejection. As the rejection progressed,the neutrophils were aggregated in the capillary bed of glomerulus. 2. The changes of acute rejection were:①the edema,congestion and bleeding of interstitial, the infiltration of lmphocyte and monocyte; ② the endarteritis, and the fibroid necrosis of the blood vessel wall.③the parenchymatous degeneration and necrosis of the epithelia of renal tuber. 3. The pathologic morphology of chronic rejection was marked by the proliferative changes. It is concluded that: 1. The red blood cells might take part in hyperacute rejection and the red blood cells and neutrophils might have a two fold function in hyperacute rejection, that might accelerate the renal graft damages. 2. The degree of acute rejection seemed to have no parallel relationship with the duration of renal transplantation. Based on the degree of illness and the need for clinical observation and treatment, a three grade standard of acute rejection of the pathologic changes (including mild, moderate and severe degree)was proposed.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
1997年第5期344-346,共3页
Medical Journal of Chinese People's Liberation Army
基金
全军八五攻关课题
