课题背景：课题在北京市首都医学发展科研基金的资助下观察肾脏移植物穿刺活检标本中血管内皮细胞被受体内皮细胞替代（内皮嵌合）的情况，分析内皮替代现象的影响因素。

应用要点：文章观察肾脏移植物血管内皮细胞被受者细胞所替代的现象，分析其相关因素，并对血管内皮细胞嵌合现象与免疫耐受的关系进行了初步探讨。初步认为血管内皮细胞替代的发生与排斥反应无明显相关性，但与冷缺血时间有关。

同行评价：文章通过观察移植肾穿刺活检标本中血管内皮细胞嵌合现象，分析内皮替代与排斥反应及冷缺血时间的相关性，有一定临床意义。

摘要
目的: 移植受者来源的内皮细胞出现在供者移植物中，替代原有的细胞，称为内皮替代，也称内皮嵌合。使用X，Y染色体探针通过荧光原位杂交法观察移植肾中血管内皮细胞被受体内皮细胞替代的情况，并分析内皮细胞替代的影响因素。
方法：①收集解放军总医院第二附属医院病理科和北京大学医学部病理系1996-01/2005-12归档的移植肾穿刺活检符合男性供者、女性受者的石蜡包埋标本34例。②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法，观察移植肾穿刺活检标本的内皮替代现象，分析其与排斥反应及冷缺血时间的关系。
结果：①肾脏移植物中血管内皮细胞替代现象存在较为普遍，17例移植肾出现内皮细胞替代。②血管内皮细胞替代的发生与排斥反应无明显相关性（P > 0.05）。③发生内皮细胞替代的移植肾冷缺血时间长于无替代移植肾（P < 0.05）。
结论：内皮细胞替代与排斥反应的发生无明显关系，移植肾冷缺血时间延长可促进血管内皮细胞替代的发生。
关键词：肾移植；移植物排斥；原位杂交，荧光；内皮/细胞学

柏宏伟，曾瑄，钟定荣，石炳毅，钱叶勇，那彦群，武莎菲. 肾脏移植物血管内皮细胞替代现象[J].中国组织工程研究与临床康复，2008，12(5):813-816 [www.zglckf.com/zglckf/ejournal/upfiles/08-5/5k-813(ps).pdf]

Endothelial chimerism in renal allograft

Abstract

AIM：Endothelial chimerism refers to endothelial cells from recipients replace original cells. This study investigated endothelial chimerism and its influential factors with X and Y chromosome probes by fluorescence in situ hybridization.
METHODS: ①Paraffin-embedded 34 samples (male donor and female recipient) undergoing renal needle biopsy were selected at the Department of Pathology of Second Affiliated Hospital of General Hospital of Chinese PLA and Department of Pathology of Medical College of Peking University from January 1996 to December 2005. ②DNA section of Yq12 (heterochromatic region) of Y chromosome was considered a probe, and a probe of centric region (α satellite DNA) of X chromosome was considered a control. Paraffin-embedded tissue sections of renal biopsy samples were examined by two-color fluorescence in situ hybridization to observe the endothelial chimerism and analyze the relationship with rejection and cold ischemia time.
RESULTS: ①Endothelial chimerism was common in renal transplantation. Seventeen cases developed endothelial chimerism. ②There was no significant correlation between endothelial chimerism and rejection (P > 0.05). ③The cold ischemia time in the chimerism group was longer than in the non-chimerism group (P < 0.05).
CONCLUSION: No correlation is found between endothelial chimerism and graft rejection. Prolonged cold ischemia time enhances the occurrence of endothelial chimerism.

Bai HW, Zeng X, Zhong DR, Shi BY, Qian YY, Na YQ, Wu SF. Endothelial chimerism in renal allograft.Zhongguo Zuzhi Gongcheng Yanjiu yu Linchuang Kangfu 2008;12(5):813-816(China) [www.zglckf.com/zglckf/ejournal/upfiles/08-5/5k-813(ps).pdf]