抗人类白细胞抗原Ⅰ类、Ⅱ类IgG抗体在同种带瓣大动脉移植后的免疫表达  

Expression of class Ⅰ and class Ⅱ anti-HLA antibodies after implantation of cryopreserved valved allograft

作　　者：郑晓舟 李守先 张刚[2] 张广福[3] 

机构地区：[1]齐鲁医院心外科,山东济南250012 [2]泰安市中心医院胸心外科,山东泰安271000 [3]济南军区总医院心外科,山东济南250031

出　　处：《山东大学学报（医学版）》2005年第12期1155-1158,共4页Journal of Shandong University:Health Sciences

摘　　要：目的:探讨先天性心脏病患者移植液氮保存同种异体带瓣大动脉(CVH)后抗人类白细胞抗原(HLA)Ⅰ类、Ⅱ类IgG抗体的免疫表达规律。方法:选择2001年10月至2003年10月施行液氮保存的CVH移植术的20例复杂先心病患者,分别于术前、术后1个月、3个月、1年不同时间点,以莱姆德抗原板通过酶联免疫吸附方法检测患者血清内的抗HLA-Ⅰ类、Ⅱ类IgG抗体,并与同期施行其他复杂先心病矫正术的20例患者进行比较。结果:所有患者术前抗体为阴性,CVH移植患者在术后1个月、3个月和1年时抗HLA-Ⅰ类抗体阳性率分别为(9.28±6.64)%、(62.14±11.95)%和(66.79±13.42)%,Ⅱ类抗体阳性率分别为(22.92±15.74)%、(41.67±18.73)%、(52.92±20.01)%,且1年内两类抗体的阳性率均呈上升趋势,对照组患者则全为阴性;两类抗体表达阳性率与患者年龄呈负相关。结论:液氮保存的CVH移植后可诱导受体产生抗HLA-Ⅰ类、Ⅱ类IgG抗体介导的体液免疫反应,而且患者年龄越小这种反应越强烈。Objective： To explore the humoral immunological response induced by class Ⅰ and class Ⅱ anti-human leucocyte antigen （HLA） antibodies after implantation of conduit valved homograft（CVH）. Methods： From October 2001 to October 2003, 20 patients suffered from complex congenital heart disease （CHD） underwent transplantations of cryopreserved homografts artery. The other 20 complex CHDs underwent corrected operation without CVH implantations. The serums were taken and the frequency of panel reactive antibodies directed against HLA class Ⅰ （HLA-A, B, and C）and class Ⅱ （HLA-DR/DQ） alloantigens were detected by LAT ELISA kit before and 1 month, 3 months, lyear after operation. Results： The antibodies were both negative before and after operation in control patients. In CVH implanted patients, the frequency of panel reactive antibodies against HLA class Ⅰ was （9.28±6.64）% at 1 month, （62.14±11.95）% at 3 months and （66.79±13.42）% at 1 year after CVH implantation; that against HLA class Ⅱ was （22.92±15.74）% at 1 month, （41.67±18.73）% at 3 months and （52.92±20.01）% at 1 year after operation. And the panel reactive trequency of class Ⅰ and class Ⅱ anti-HLA antibodies presented an upward trend within 1 year and a negative correlation with age. Age negatively correlated with the degree of elevation of class Ⅰ and class Ⅱ anti-HLA antibodies. Conclusion： Implantation of CVH can induce a marked humoral immunological response involved class Ⅰ and class Ⅱ anti-HLA antibodies; this response is stronger in young than in eld.

关 键 词：人类白细胞抗原 免疫抗体 动脉移植 免疫表达 IGG抗体 带瓣大动脉 先天性心脏病 

分 类 号：R654.3[医药卫生—外科学]