抗HLA-Ⅱ类抗体与HLA配型对移植肾长期存活的研究  

A study of influence of HLA-Ⅱ antibody and HLA match to renal long term survival

作　　者：贾保祥[1] 林俊[1] 苏建荣[2] 马威然[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 [2]首都医科大学附属北京友谊医院检验科,北京100050

出　　处：《国际检验医学杂志》2013年第7期793-794,共2页International Journal of Laboratory Medicine

基　　金：北京友谊医院科研启动基金资助项目(2009-24)

摘　　要：目的研究肾移植术后抗HLA-Ⅱ类抗体阳性患者HLA配型与移植肾长期存活的关系。方法肾移植供受者HLA分型及群体反应性抗体检测均采用美国莱姆德公司提供试剂。血肌酐为判断肾功能的指标,检测数据由检验科提供。结果 2007年检测出的143例抗HLA-Ⅱ类抗体阳性患者中,HLA-A、B、DR抗原3个以下错配的患者54例,目前肾功能较差患者11例,36例患者肾功能正常。7例患者移植肾失功。HLA-A、B、DR抗原3个错配的患者(非半相合)14例,目前8例患者移植肾功能正常,1例患者肾功能较差,5例患者移植肾功能丧失。HLA-A、B、DR抗原4个错配的患者48例,目前27例患者移植肾功能正常,11例患者肾功能较差,10例患者移植肾功能丧失。HLA-A、B、DR抗原5～6个错配的患者27例。目前6例患者移植肾功能正常,8例患者肾功能较差,13例患者移植肾功能丧失。HLA-A、B、DR抗原3个错配以下与错配4个抗原以上的患者,5年后移植肾功能下降或丧失的比较,差异有统计学意义(P<0.05)。结论抗HLA-Ⅱ类抗体是移植肾功能丧失的重要因素之一,但良好的供受者HLA配型可提高移植肾长期存活。Objective To study the relation between HLA match and renal long term survival in HLA-Ⅱ antibody positive pa- tients. Methods Anti-HLA-Ⅱ class antibodies and HLA typing was detected in 143 patients by ELISA and SSP. Serum creatinine and urea nitrogen level was offered by clinical laboratory. Results 143 HLA-Ⅱ antibody positive patients, in which, 54 patients showed no more than 3 locus mismatch, renal function was normal in 36 patients, renal function was in bad condition in 11 patients, 7 patients lose renal function. 14 patients showed 3 locus mismatch（ half match） ,in which 8 patients showed good condition of renal function,1 patients showed bad condition of renal function, 5 patients lose renal function. 48 patients showed 4 locus mismatch,in which 27 patients showed normal renal function now, 11 patients with bad condition of renal function, 10 patients lose renal func- tion. 27 patients showed 5-6 locus mismatch,in which 6 patients with good renal function, 8 patients with bad condition of renal function, 13 patients lose renal function. There was significant difference between now more than 3 locus mismatch and more than 4 locus mismatch in renal function lose and decrease after 5 years transplantation, the difference was statically significant（P〈0.05）. Conclusion HLA-Ⅱ antibody was one of the important factors causing graft function lose,however,perfect HLA match could im- prove renal long term survival rate.

关 键 词：肾移植 HLA抗原 抗体 

分 类 号：R699[医药卫生—泌尿科学]