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目的:观察慢性移植肾肾病(CAN)中血管内皮细胞被受者内皮细胞替代(内皮嵌合)的现象,分析内皮嵌合对CAN进展的影响。方法:无功能移植肾切除组织,符合慢性移植肾肾病(CAN)造成移植肾失功、男性供者女性受者标本29例,选择Y染色体长臂Yq12区域(异染色质区)DNA片段作为探针,同时选择X染色体着丝粒区(α卫星DNA)探针作为对照,通过在石蜡切片标本上进行间期细胞双色荧光原位杂交(FISH),观察肾小管周毛细血管(PTC)内皮细胞的嵌合程度。结果:CAN中PTC内皮细胞嵌合现象较普遍存在,内皮细胞的分布呈灶状,供者内皮细胞和受体内皮细胞可相邻存在。PTC密度与间质纤维化程度有关,CD31阳性的PTC每单位面积密度14.52±4.85个,微血管内皮细胞嵌合出现比例为0.16±0.04,两者无明显相关性(r=0.13,P>0.05)。结论:肾脏移植物中血管内皮细胞可以被受者来源的内皮细胞所替代,CAN中PTC密度减少,内皮细胞的嵌合的发生与CAN的进展无直接关系。
OBJECTIVE: To observe the phenomenon of endothelium replacement (endothelial chimerism) of vascular endothelial cells in chronic allograft nephropathy (CAN) and to investigate the effect of endothelial chimerism on the progression of CAN. Methods: Non-functional nephrectomy was performed in 29 cases of transplanted renal failure caused by chronic allograft nephropathy (CAN). Female DNA samples of Yq12 (heterochromatic region) of Y chromosome were selected as probe The X-ray centromeric region (α-satellite DNA) probe was also used as a control. Peripheral blood cell double-color fluorescence in situ hybridization (FISH) was performed on paraffin-embedded sections to observe the changes of renal tubular pericytes (PTC) endothelial cells The degree of chimerism. Results: The phenomena of chimerism in PTC endothelial cells were more common in CAN and the distribution of endothelial cells was focal. The endothelial cells and the endothelial cells of donor cells could be adjacent to each other. The density of PTC was related to the degree of interstitial fibrosis. The density of CD31 positive PTC per unit area was 14.52 ± 4.85, and the percentage of microvascular endothelial cell chimerism was 0.16 ± 0.04. There was no significant correlation between them (r = 0.13, P> 0.05) . CONCLUSION: Vascular endothelial cells in kidney grafts can be replaced by endothelial cells derived from recipients. The density of PTC in CAN is reduced and the occurrence of endothelial cell chimerism is not directly related to the progression of CAN.