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目的 :观察大鼠异体异位心脏移植术后不同时间点 ,淋巴细胞相关免疫分子的表达水平、供心存活率及心肌组织的病理学改变 ,探讨免疫排斥反应的相关时间进程。方法 :分别经供体SD大鼠的心脏主动脉、肺动脉与受体Wistar大鼠的腹主动脉及下腔静脉吻合 ,进行异位心脏移植术。于术前及术后不同时间点 ,取血分离淋巴细胞。用流式细胞仪分别检测淋巴细胞上CD4、CD8、IL 2R、ICAM I和MHC II类分子的表达水平。对供心心肌组织进行常规病理学检查。结果 :于移植后2 4h ,只有MHC II类分子的表达水平增加 ,CD4、IL 2R和I CAM I的表达水平降低 ,CD8无改变。术后 72h,CD4、CD8及IL 2R的表达增加 ,其中CD8和IL 2R达峰值。术后 7～ 10d ,除CD4的表达继续增加外 ,其他 4种免疫分子的表达水平逐渐降低。术后不同时间点移植心脏的存活率分别为 :10 0 % (2 4h)、85 .7% (72h)、16 .7% (7d)、0 (10d和 12d)。病理学检查显示 ,移植后 2 4h ,心肌组织无明显的病理学变化 ,术后 3d ,7只大鼠中 4只出现ⅠA级及以上病理改变。术后 7d ,6只大鼠全部发生Ⅱ级以上的病理学变化。结论 :大鼠心脏移植后的 2 4h内 ,外周血淋巴细胞为以MHC II分子表达为主的抗原识别、呈递期 ,并伴有一过性免疫功能降低 ;术后 2 4～ 72h为T细胞活化期 ,术后
OBJECTIVE: To observe the expression of lymphocyte-associated immune molecules, the survival rate of donor hearts and the pathological changes of myocardium at different time points after allo-heterotopic heart transplantation in rats, and to explore the related time course of immune rejection. METHODS: Ectopic heart transplantation was performed by anastomosing the abdominal aorta and inferior vena cava of the donor’s aorta, pulmonary artery and recipient Wistar rats respectively. Preoperative and postoperative different time points, blood from lymphocytes. The expression of CD4, CD8, IL2R, ICAM I and MHC class II molecules on lymphocytes were detected by flow cytometry. On the heart of myocardial tissue for routine pathological examination. Results: At 24 hours after transplantation, only the expression of MHC class II molecules increased, the expression levels of CD4, IL2R and I CAM I decreased, and CD8 remained unchanged. After 72h, the expression of CD4, CD8 and IL 2R increased, of which the peak of CD8 and IL 2R. At 7-10 days after operation, the expression of four other immune molecules decreased gradually except for the increase of CD4. Survival rates of transplanted heart at different time points after surgery were 100% (24 h), 85.7% (72 h), 16.7% (7 d), 0 (10 d and 12 d), respectively. Pathological examination showed that at 24 hours after transplantation, there was no obvious pathological changes in myocardial tissue. Three days after operation, 4 of 7 rats showed grade ⅠA and above pathological changes. At 7 days after operation, pathological changes of grade Ⅱ or higher occurred in all 6 rats. CONCLUSION: Within 24 hours after heart transplantation, peripheral blood lymphocytes are antigen-presenting and presenting with MHC II expression as the main component, accompanied by a transient decrease in immune function. T cells are activated at 24 to 72 hours after operation Period, postoperative