目的 探討細胞凋亡和相關(guān)因子Fas、 FasL、 bcl-2和bax在大鼠胰腺移植急性排斥反應中的作用，評價十二指腸黏膜活檢在胰腺移植中診斷排斥反應的價值。
方法 選SD 和 Wistar大鼠行全胰十二指腸移植，實驗分同基因胰腺移植組和異基因胰腺移植組。于移植術(shù)后第3、5及7 d分批處死受體，取移植胰腺和十二指腸標本用HE染色和原位末端脫氧核糖核苷酸轉(zhuǎn)移酶標記技術(shù)（TUNEL）檢測移植物。免疫組化法檢測移植后胰腺和十二指腸Fas、 FasL、bcl-2和bax的表達。
結(jié)果 異基因胰腺移植組胰腺和十二指腸病理評分相同者占61.1%（11/18）； 評分不同者占38.9%（7/18），其中胰腺評分較高者6例， 十二指腸黏膜評分較高者僅1例。 異基因胰腺移植組胰腺和十二指腸病理學評分和細胞凋亡指數(shù)均明顯高于同基因胰腺移植組(P＜0.05，P＜0.01)。胰腺和十二指腸細胞凋亡指數(shù)與急性排斥反應的病理學評分成正相關(guān)(r=0.965，P＜0.01； r=0.942，P＜0.01)。隨著術(shù)后時間延長,排斥反應分級上升,細胞凋亡增加, FasL表達升高，在異基因移植組bcl-2表達下降，而Fas和bax表達無明顯變化。
結(jié)論 細胞凋亡與移植胰腺急性排斥反應的嚴重程度呈正相關(guān),細胞凋亡指數(shù)可作為判斷移植物損傷程度的指標。FasL和bcl-2與胰腺移植急性排斥及組織損傷密切相關(guān)。十二指腸黏膜活檢有助于判斷有無胰腺急性排斥反應發(fā)生。
引用本文： 李濤,羅軍,溫浩. 細胞凋亡在大鼠胰腺移植急性排斥反應中的作用. 中國普外基礎與臨床雜志, 2007, 14(1): 59-62. doi: 復制
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