中文摘要：

目的研究同种异体肾移植术后急性血管性排斥患者动脉内膜炎的细胞类型及其与管周毛细血管（PTC）C4d沉积的关系。方法共纳入20例自2006年6月至2008年6月在本中心行同种异体肾移植手术后肾功能异常且病理证实为急性血管性排斥受者的21份肾活检组织。免疫组化方法检测同一活检标本连续切片内T细胞表面标记物CD3、巨噬细胞表面标记物CD68及体液性排斥特异性标记物C4d的表达情况。根据PTCC4d的沉积情况将患者分为C4d阳性（C4d＋）组和C4d阴性（C4d-）组，定量计数中动脉内膜阳性细胞数，并计算每个中动脉横切面的平均细胞数。结果急性血管性排斥患者动脉内膜都以巨噬细胞浸润为主；C4d＋组和C4d-组患者的动脉内膜都以巨噬细胞浸润为主，与浸润的T淋巴细胞数相比差异均有统计学意义[（12．45±9．86）个／中动脉横切面比（3．91±3．03）个／中动脉横切面，P=0．007；（3．47±1．89）个／中动脉横切面比（1．45±1．37）个／中动脉横切面，P=0．0061，且C4d＋组患者动脉内膜巨噬细胞浸润数量显著多于C4d-组（P=0．007）。结论肾移植术后急性血管性排斥患者动脉内膜以巨噬细胞浸润为主，且与PTCC4d的沉积有相关性。C4d＋患者动脉内膜巨噬细胞数显著多于C4d-患者。

英文摘要：

Objective To investigate the cell types of renal allograft intimal arteritis in posttransplantation patients and its relationship with peritubular capillaries （PTCs）C4d deposition. Methods Twenty allograft kidney transplant recipients from Jun 2006 to Jun 2008 were enrolled in the retrospective study. Twenty-one biopsy specimens with acute vascular rejection were immunostained for macrophages, T cells and C4d. In each biopsy specimen, arterial intimal macrophages and T cells were counted, and mean number of macrophages per artery and T cells per artery were determined. The recipients were divided into C4d ＋ and C4d- group according to whether C4d deposition in the PTCs. Results In the intimal arteritis of biopsies diagnosed as acute vascular rejection, the infiltrating cells were predominantly macrophages including C4d＋ and C4d- group. T cells were the minority. The mean macrophage number per artery cross-section was significantly higher than the mean T cell number per artery cross-section in the C4d ＋ group （12.45±9.86 vs 3.91±3.03, P=0.007） and in the C4d- group （3.47±1.89 vs 1.45±1.37, P=