【摘要】 目的　用大鼠皮肤致敏模型研究氨甲蝶呤供者预处理对移植心脏成活的影响及其与术后抗排斥治疗的协同效果。　方法　ＳＤ 大鼠作供者，Ｗｉｓｔａｒ 大鼠作受者，所有受者在心脏移植前均先用供者皮肤致敏，依据受者治疗和供者预处理情况的不同，将４８ 只Ｗｉｓｔａｒ 大鼠随机分成对照组、供者预处理组、受者治疗组和协同治疗组，每组各１２ 只。（１） 对照组作非供者预处理的供者心脏移植；（２） 供者预处理组作经供者预处理后的供者心脏移植；（３） 受者治疗组作非供者预处理的供者心脏移植后用环孢素Ａ（ＣＳＡ）１００ｍｇ／ｋｇ·ｄ 治疗３ 天；（４） 协同治疗组作经供者预处理后的供者心脏移植，再用ＣＳＡ 治疗３ 天。观察４ 组手术前后红细胞免疫指标的动态变化，供者心脏移植后存活时间，淋巴细胞增殖反应，供者心脏超微结构等变化。　结果　在细胞和体液免疫均较强的内环境中，供者预处理组和协同治疗组的移植供者心脏成活时间均较对照组和受者治疗组明显延长。　结论　氨甲蝶呤供者预处理能明显延长移植供者心脏成活时间，并与术后对受者的免疫抑制治疗有协同效果，该法简单、实用，对降低术后免疫抑制剂用量和毒副作用有一定的意义。更多还原

【Abstract】 Objective Using donor skin sensitized recipients and intra abdominal heterotopic cardiac transplant procedure,we investigated the effect of donor pretreatment with methotrexate on the mean survival time of cardiac allograft and its synergistic effects with immunosuppressant therapy. Methods SD rats were used as skin and heart donor and Wistar rats used as recipient.All recipients were sensitized with donor skin transplantation before heart transplantation.According to the methods of treatment to the donors and recipients,48 rats were divided in to 4 groups;(1)simple heart transplantation as control group, (2)pretreated donor heart for transplantation (donor pretreated group),(3)unpretreated donor heart for transplantation followed with cyclosporin A 100mg/kg·d for 3 days to the recipient (recipient treated group),and (4)pretreated donor heart was transplanted and followed with cyclosporin A treatment (combined treatment group).Red blood cell immunity and lymphocyte blastogenesis were determined,mean survival time of cardiac allografts and its microscopic examination were observed. Results In the environment of intensified humoral and cell mediated immunity,the mean survival time of cardiac allografts was much prolonged in donor pretreated group and combined treatment group in compared with those in control group and recipient treated group respectively. Conclusion Donor pretreatment with methotrexate could increase the survival time of cardiac allografts,if it is combined with those of postoperative immunosuppressive therapy a synergistic effects will be achieved.This method could allow reduction in the dose of immunosuppressant drugs to the recipient and thus lessen the toxicity of immunosuppressant therapy.更多还原