CAJ | 학술논문

目的总结制作稳定的大鼠慢性移植肾肾病(CAN)动物模型的经验.方法以F344近交系大鼠为供者,取供者左肾作为供肾,原位低温灌注;以Lewis近交系大鼠为受者,行左侧原位肾移植,供肾动脉与受者腹主动脉端侧吻合,供肾静脉与受者肾静脉端端吻合,输尿管带膀胱瓣与受者膀胱吻合.术后用环孢素A灌胃10 d,剂量为10 mg·kg-1·d-1.每月采集受者血液和尿液,测定血肌酐及24 h尿蛋白,分别于术后2、4个月获取移植肾进行病理检查.结果 45只进行移植,手术成功率为85%,单次手术时间为(120±20)min.移植后1个月,大鼠即出现血肌酐、尿素氮及血胱抑素升高,24 h尿蛋白增加,与术前相比,各项指标均升高(P<0.05);术后2个月及4个月,除尿蛋白继续增加外,其余观察指标上升不明显.移植术后2个月,移植肾有轻度至中度的间质纤维化,淋巴细胞和浆细胞的浸润;4个月时,移植肾可见广泛的间质纤维增生,间质细胞大量浸润,肾小球基底膜增厚、硬化、闭塞,肾小管萎缩退化,符合CAN的病理改变.结论通过充分的手术强化训练及改进,规范大鼠取、肾、移植术中、术后管理的每个细节,大鼠CAN模型的成功率及稳定性高.
목적 총결제작은정적대서만성이식신신병(CAN)동물모형적경험.방법 이F344근교계대서위공자,취공자좌신작위공신,원위저온관주;이Lewis근교계대서위수자,행좌측원위신이식,공신동맥여수자복주동맥단측문합,공신정맥여수자신정맥단단문합,수뇨관대방광판여수자방광문합.술후용배포소A관위10 d,제량위10 mg·kg-1·d-1.매월채집수자혈액화뇨액,측정혈기항급24 h뇨단백,분별우술후2、4개월획취이식신진행병리검사.결과 45지진행이식,수술성공솔위85%,단차수술시간위(120±20)min.이식후1개월,대서즉출현혈기항、뇨소담급혈광억소승고,24 h뇨단백증가,여술전상비,각항지표균승고(P<0.05);술후2개월급4개월,제뇨단백계속증가외,기여관찰지표상승불명현.이식술후2개월,이식신유경도지중도적간질섬유화,림파세포화장세포적침윤;4개월시,이식신가견엄범적간질섬유증생,간질세포대량침윤,신소구기저막증후、경화、폐새,신소관위축퇴화,부합CAN적병리개변.결론 통과충분적수술강화훈련급개진,규범대서취、신、이식술중、술후관리적매개세절,대서CAN모형적성공솔급은정성고.
Objective To summarize the experience of establishing the stable rat model of chronic allograft nephropathy. Methods We used Fisher rats as donors and Lewis rats as recipients.After the left kidney of the donor perfused in situ under hypothermic condition, the left renal vein,abdominal aorta and bladder flap of the donor was anastomosed with the left renal vein, renal artery and bladder of the recipient, respectively. The recipients were given cyclosporin oral solution 10 mg/kg every day by gavage for 10 days after transplantation. The blood and urine samples were collected 1 month, 2 months and 4 months after transplantation and renal function and total urine protein were examined. The pathological changes of the renal allograft were observed 2 and 4 months after transplantation. Results Forty-five rats received operation and achievement ratio was 85%. The renal transplantations were finished in 120 ± 20 min. The Scr, BUN, Cycs and total urine protein demonstrated a significant increase one month after transplantation. On the second and fourth month,with the exception of urine protein continued to increase, the other indicators did not change significantly. Two months after transplantation renal pathology demonstrated light to moderate interstitial fibrosis, infiltration of lymphocytes and plasma cells. At 4th month the renal allografts showed extensive interstitial fibrosis, a large number of infiltrating interstitial cells, thickening,hardening, occlusion of glomerular basement membrane, and renal tubular atrophy that were consistent with pathological changes of chronic allograft nephropathy. Conclusion Through adequate surgical training and improvement, and specification for rat nephrectomy, transplantation surgery,and postoperative management in every detail, the model with high success rate and stability can be achieved.