抗HLA-II类抗体和抗MICA抗体对移植肾存活的影响  

The influence of HLA-II antibody and MICA antibody on survival of renal transplant

作　　者：贾保祥[1] 武俊杰[1] 徐秀红[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：《临床和实验医学杂志》2014年第1期7-10,共4页Journal of Clinical and Experimental 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患者抗HLA-II抗体和抗主要组织相容性复合物I类相关链A基因(MICA)抗体与移植肾存活的关系。方法对首都医科大学附属北京友谊医院2008年前手术的321肾移植患者,于2009年12月至2010年6月检测群体反应性抗体(PRA)和抗MICA抗体,PRA检测采用美国莱姆德公司酶联免疫吸附法(ELISA)抗原板检测抗HLA抗体,抗MICA抗体检测采用流式筛查技术。结果 321肾移植患者中共检测出抗HLA-II类抗体阳性患者66例,抗MICA抗体阳性患者18例,分别占肾移植术后患者20.56%(66/321)和5.61%(18/321);抗体总阳性率26.17%(84/321)。66例抗HLA-II类抗体阳性患者中,9例患者肾功能正常,占13.64%(9/66);57例患者肾功能下降或丧失,占75.76%(57/66)。18例抗MICA抗体阳性患者中,肾功能正常患者2例,占11.11%(2/18);肾功能下降患者或丧失患者16例,占88.89%(16/18)。抗HLA-II类抗体和抗MICA抗体阳性与抗体阴性患者对肾功能下降的影响具有非常显著性差异(χ2=145.80,P<0.001)。结论抗HLA-II类抗体和抗MICA抗体是引起移植肾慢性失功的重要因素之一。Objective To study the relationship between HLA - II antibody, MICA antibody and survival of renal transplant after trans- plantation. Methods Panel reactive antibody （PRA） and major- histocompatibility- complex class I related chain A antibody （MICA） were tested during December 2009 to June 2010 in 321 patients with renal transplant, they received transplants before 2008 in Beijing Friendship Hospi- tal, affiliated to Capital Medical University. LAT - 1240 of One Lambda was used for PRA test, Luminex 200, MICA AbSean Kit was used for MI- CA test. The positive rate of HLA -II antibody in 66 patients reached 20.56% （66/321）, the positive rate of MICA in 18 patients of 321 trans- plants reached 5.61% （ 18/321 ）, and their total positive rate reached 26.17% （ 84/321 ）. Results Among 66 patients with positive HLA - II antibody, renal function was normal in 9 patients （ 13.64% ）, loss or decreased renal function in 57 patients （75.76%）. Among these 18 pa- tients with positive MICA, 2 patients showed normal renal function （11.11%）, 16 patients showed loss or decreased renal function. The differ- ence was significant between HLA- II antibody and positive or negative MICA on renal function of transplants（x2 = 145.80, P 〈0.001 ）. Conclusion HLA - II and MICA antibodies are two important factors that cause chronic loss of renal function in transplants.

关 键 词：肾移植 抗HLA抗体 抗MICA抗体 移植肾功能 

分 类 号：R699.2[医药卫生—泌尿科学]