抗 HLA 抗体和 MICA 抗体与移植肾存活的研究  

Anti-HLA and anti-MICA antibodies are positively correlated with transplanted kidney dysfunction

作　　者：贾保祥[1] 武俊杰[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, 100050

出　　处：《中华微生物学和免疫学杂志》2014年第3期216-219,共4页Chinese Journal of Microbiology and Immunology

摘　　要：目的：研究肾移植术后患者抗HLA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年前接受肾移植的679例患者，于2009年10月至2010年6月检测群体反应性抗体（ PRA）和MICA抗体。于近期查看移植肾功能。 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（ Luminex200，MICA AbScan Kit ）。结果679例肾移植患者中共检测出108例患者具有抗HLA抗体和/或MICA抗体，其中单纯抗HLA抗体阳性患者81例，占11．93％（81/679）；单纯抗MICA抗体阳性患者18例，占2．65％（18/679），抗HLA抗体和抗MICA抗体共同阳性患者9例，占1．33％（9/679）。81例抗HLA抗体阳性患者中，移植肾功能下降或丧失患者71例，占87．65％（71/81）；18例MICA抗体单纯阳性患者中，肾功能下降患者或丧失患者16例，占88．89％（16/18）；9例抗HLA抗体和抗MICA抗体共同阳性患者中，肾功能下降患者或丧失患者9例，占100％（9/9）。抗HLA抗体和MICA抗体阳性与阴性对肾移植患者移植肾功能的影响差异有统计学意义（χ2＝353．92，P＜0．001）。结论抗HLA抗体和抗MICA抗体与移植肾慢性失功具有高度相关性。Objective To study the correlation between transplanted kidney dysfunction and oc-currence of the panel reactive antibody （ PRA, also referred as anti-HLA antibody ） and anti-Major-Histo-compatibility-Complex class Ⅰrelated chain A （MICA） antibody.Methods The tests for detecting PRA and anti-MICA antibody were performed on 679 renal transplant patients from December , 2009 to June, 2010 who received transplantation before 2008 in Beijing Friendship Hospital .Enzyme-Linked Immunosor-bent Assay （ ELISA） was used to detect anti-HLA antibody using LAT-1240 （ OneLambda Inc .） .MICA Ab-Scan Kit was adopted to detect anti-MICA antibody .Continuous observation of graft function was conducted . Results 108 out of 679 patients showed anti-HLA antibody and/or anti-MICA antibody positive results . Among them, 81 patients were positive only for anti-HLA antibody, 18 patients were positive only for anti-MICA antibody and other 9 patients showed anti-HLA and anti-MICA antibodies double positive .Among all of the kidney transplant patients with a failed or decreased renal function , 71 patients were positive for anti-HLA antibody;16 patients were positive for anti-MICA antibody;and other 9 patients were positive for both anti-HLA and anti-MICA antibodies .The results demonstrated that anti-HLA and anti-MICA antibodies af-fected the renal functions in patient with renal transplantation （χ2 =353.92, P 〈0.001）.Conclusion Anti-HLA and MICA antibodies showed significant positive correlations with chronic allograft failure in the patients with renal transplantation .

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]