MICA抗体与移植肾慢性失功的研究  

Study of Relation between MICA Antibody and Chronic Renal Dysfunction

作　　者：贾保祥[1] 田野[1] 

机构地区：[1]首都医科大学附属北京友谊医院泌尿科,北京100050

出　　处：《现代检验医学杂志》2011年第5期134-136,共3页Journal of Modern Laboratory Medicine

基　　金：北京友谊医院科研启动基金资助项目（No.2009-24）.

摘　　要：目的 探讨肾移植术后患者抗主要组织相容性复合物I类相关链A基因（MICA）抗体与移植肾慢性失功的关系.方法 选择了1986年～2005年间在北京友谊医院接受肾移植的38例患者,男性32例,女性6例,年龄24～68岁,血肌酐和尿素氮水平高于正常值.采用MICA抗体流式筛查技术,于2009年7月检测MICA抗体和PRA抗体,38例肾移植患者PRA抗体均为阴性,而后观察一年后的肾功能变化.结果 38例肾移植术后群体反应性抗体阴性但血肌酐和尿素氮高于正常值的患者中有9例MICA抗体阳性,阳性率达23.68%.9例MICA抗体阳性患者均呈现MICA抗体多特异性.29例MICA抗体阴性患者,经过一年的治疗,7例患者肾功能基本恢复,2例患者恢复透析,20例患者肾功能基本未变.MICA抗体阳性的9例患者中有4例患者恢复透析,其MICA抗体均为强阳性;另5例患者肾功能基本未变,其MICA抗体4例为弱阳性,1例为阳性.MICA抗体阳性和MICA抗体阴性患者之间恢复透析的患者间差异有统计学意义（χ2=4.73,P〈0.025）.结论 高滴度MICA抗体是引起移植肾慢性失功的重要因素之一.Objective To investigate the relation between major histocompatibility complex class Ⅰ chain-related gene A （MICA） antibody and chronic renal dysfunction in post-transplant patients. Methods 38 Tx recipients in Beijing Friend- ship hospital （1986～2005）,32 male and 6 female;the oldest was 68 years old and the youngest was 24 years old,both the level of serum creatinine and urea nitrogen were higher than normal. MICA antibody was tested in July,2009 using MICA antibody flow-screen method（Luminexl00,MICA AbScan Kit）. Then one year renal function was observed. Results 9 pa- tients showed MICA antibody positive （9/38,23.68 %0）, furthermore, the 9 patients showed multivalent MICA antibody positive. 29 patients,who showed MICA antibody negatve,in which 7 patients recovered after one year therapy,2 patients returned to dialysis,renal function got no change in the other 20 patients. 9 patients MICA antibody positive,in whlch,4 patients who showed strong positive returned to dialysis,and 5 patients renal function with no change,with 4 patients showed weak positive and 1 patients positive. After 1 year,there were 9 cases of positive MICA,in 4 case of which recuper- ate dialysis. Two case of recuperate dialysis occurred in negative MICA group. The difference was significant（χ2=4.73,P 〈0. 025）. Conclusion High titer MICA antibody was one of the important factors that cause transplant renal chronic dysfunction.

关 键 词：肾移植 主要组织相容性复合物I类相关链A基因(MICA) 移植肾功能 

分 类 号：R699.2[医药卫生—泌尿科学] R392.11[医药卫生—外科学]