【摘要】 目的　在大型动物 (猪 )上建立同种异体肢体移植模型 ,探讨同种异体肢体移植中组织学改变 ,以及皮肤排斥反应的机制。方法　对 9只不同窝的猪进行前肢移植 ,其中 3例为未用药组 ,6例为用药组。分别在术后不同时间对移植体的皮肤进行了 72次活检病理组织学检查 ,以术前皮肤为对照。采用S P免疫组化法进行CD3、CD4、CD8检测。结果　术后皮肤均在不同时期发生了不同程度的排斥反应。未用药组发生了严重排斥反应 ,移植肢体在 1周内坏死。用药组在免疫抑制剂的作用下 ,移植肢体获得了长期存活。皮肤的排斥反应中CD3均有不同程度表达 (10 0 % ) ;CD4及CD8表达分别为 (2 3 6 1% )及(9 72 % ) ,主要表达在发生严重排斥反应的病例中。结论　同种异体肢体移植在免疫抑制剂的作用下可获得长期存活。皮肤的病理组织学检查是诊断排斥反应的可靠依据。皮肤的排斥反应可能主要为一种T细胞介导的细胞免疫反应 ,T淋巴细胞亚群的监测有助于判断移植肢体的存活和诊断排斥反应的发生更多还原

【Abstract】 Purpose To investigate histological findings and mechanisms of skin rejection of limb allotransplantation in a pig model. Method Nine pigs from different litter were given forefoot allotransplantation, and divided in to drug-used group (6 pigs) and non-drug-used group (3 pigs). Allotransplanted limb’s skin biopsies (seventy-two) were performed for histopathological examination, and preoperative skin was used as control. S-P immunohistological method was used to detect the expression of CD3, CD4 and CD8. Results Different degree of rejection was found in all skin. Severe rejection was found in skin in non-drug-used group and allotransplanted limbs became necrotic in one week after transplantation. Allotransplanted limbs in drug-used group survived for a long time because of the action of immunosuppressive drugs. CD3 expressed in all skin rejection (100%); CD4 expressed rate was 23.61% and CD8 was 9.72%, which mainly expressed in those cases that severe rejection had been found. Conclusions Allotransplanted limbs can survive for a long time by use of immunosuppressive drugs. Histopathological examination is reliable for diagnosing rejection. Skin rejection may be a T-cell-mediated cellular immunity, and thus monitoring of T-lymphocyte subgroup may help for judging survival of transplanted limbs and diagnosisof rejection.更多还原