【摘要】 目的探讨移植肾组织及血清中透明质酸（HA）、层粘连蛋白（LN）及Ⅳ型胶原(C_-Ⅳ)含量与急性排斥反应的关系。方法以雄性SD大鼠为供者,Wistar大鼠为受者,采用改进的Blom法制作大鼠原位左肾移植模型,设同种移植对照组、同种移植用药组(术后腹腔注射环孢素A 10 mg·kg^-1·d^-1),另设同系移植组（供、受者均为Wistar大鼠）和假手术组（Wistar大鼠仅切除右肾,不行移植）,每组20只大鼠。每组分别于术后3、5、7及9 d各随机选取5只大鼠,从下腔静脉采血2 ml,随后切取移植肾（假手术组切取左侧肾脏）,用放射免疫分析法测定肾组织匀浆及血清中HA、LN及C_-Ⅳ的含量,并行肾组织切片,根据“Banff 97”标准进行病理诊断。结果从术后5d开始,同种移植对照组的肾组织匀浆及血清中HA、LN及C_-Ⅳ的浓度均显著高于同系移植组、假手术组及同种移植用药组（P＜0．01）；血清中HA、LN及C_-Ⅳ的浓度与肾组织匀浆中HA、LN及C_-Ⅳ的浓度呈正相关（r分别为0．960、0．934和0．847,P值均为0．000）。病理检查证实,同种移植对照组共有17个肾脏发生急性排斥反应,同种移植用药组共有4个肾脏发生急性排斥反应,它们的Banff急性排斥反应指数与移植肾组织匀浆中及血清中HA、LN及C_-Ⅳ的浓度均呈正相关（P＜0．01）。结论HA、LN及C_-Ⅳ在肾移植急性排斥反应的发生及发展中起重要作用,肾移植术后监测血清中HA、LN及C_-Ⅳ的浓度有助于急性排斥反应的诊断。更多还原

【Abstract】 Objective To study the change of the hyaluronic acid （HA）,laminin （LN） and col- lagen type IV (C_?) within the renal grafts and in serum during acute rejection and to investigate their relationship.Methods Male Wistar and Sprague-Dawley rats were used as donors and recipients,re- spectively.Rat orthotopic kidney transplantation was performed according to a modification of the method decribed by Biota.Experimental rats were randomly divided into 4 groups,homotransplanta- tion rats treated with cyclosporine,isotransplantation,pseudooperation and controls.Animals were subsequently killed at defined time points for determination of the extracellular matrix （ECM） parame- ters (HA,LN and C_?) within the graft and in serum by radioimmunoassay.Results Significant increases in HA,LN and C_? levels within the renal grafts were found in the rejection group as compared with the non-rejection groups.Serum levels of HA,LN and C_? were also significantly elevated in the rejection group at diagnosis of rejection.Serum HA,LN and C_? levels were correla- ted with those within the renal grafts.Histologic examination revealed that 4 cases developed acute re- jection in homotransplantation rats treaded with cyclosporine,17 cases in controls.HA,LN and C_? levels within the renal grafts were correlated with acute rejection Banff scores.There was correlation between serum levels of HA,LN and C_? and acute rejection Banff scores （P＜0.01）.Conclusion HA,LN and C_? play an important role in the pathogenesis of acut allograft rejection.In addition, serum levels of HA,LN and C_? may be a sensitive marker of acute rejection in the postoperative period of renal transplantation.更多还原