抗人类白细胞抗原抗体与抗内皮细胞抗体在肾移植慢性排斥反应中作用的相关性  

The correlation between anti-human leukocyte antibody and anti-endothelial cell antibody in chronic re- jection after renal transplantation

作　　者：孙文英[1] 姜静[2] 李兴库[3] 王金辉[4] 权奇善[1] 黄丽娟[1] Sun Wenying Jiang Jing Li Xingku Wang Jinhui Quan Qishan Huang Lijuan(Department of Laboratory, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China （ Sun WY, Quan Qs ,Huang L J Infection Management Section, Heilongjiang Provincial Hospital, Harbin 150001, China （ Jiang J Research Center,the Second Affiliated Hospital of Harbin Medical University,Harbin 150086,China（ Li XK Department of Laboratory,the First Hospital of Harbin,Harbin 150010, China（ Wang JH)

机构地区：[1]哈尔滨医科大学附属第二医院检验科,150086 [2]黑龙江省医院感染管理科,哈尔滨150001 [3]哈尔滨医科大学附属第二医院科研实验中心,150086 [4]哈尔滨市第一医院检验科,150010

出　　处：《国际免疫学杂志》2017年第5期493-496,共4页International Journal of Immunology

基　　金：教育部“春晖计划”科研项目（Z2010001）;黑龙江省卫生厅科研课题（2010-067）

摘　　要：目的 选择发生慢性排斥反应的肾移植患者，根据人类白细胞抗原（human leukocyte antigen，HLA）抗体阳性或抗内皮细胞抗体阳性以及两抗体同时阳性进行分组，并同时检测各组患者的血清中肌酐含量作为判断肾功能的指标。探讨在肾移植慢性排斥反应中抗内皮细胞抗体与抗HLA抗体作用的相关性。方法 抗内皮细胞抗体的检测方法用免疫荧光法，抗HLA抗体应用酶联免疫吸附试验（enzyme linked immunosorbent assay，ELISA），肌酐检测应用的是生化分析仪。结果 移植后处于慢性排斥期抗HLA抗体阳性的患者血清肌酐含量均值为（116.3±5.6）μmol/L，抗内皮细胞抗体阳性的患者血清肌酐含量均值为（114.6±4.7）μmol/L；抗HLA抗体与抗内皮细胞抗体同时阳性的血清标本肌酐含量的中位数是131.2 μmol/L，四分位间距为13.6 μmol /L；两组间肌酐含量差异有统计学意义（P＝0.000）。结论 抗内皮细胞抗体和抗HLA抗体均可影响肾移植慢性排斥反应期的肾功能；抗内皮细胞抗体与抗HLA抗体在肾移植慢性排斥期间同时产生，肾功能损害加重。Objective To explore the role of anti-endothelial cell antibody and anti-haman leukocyte antigen（HLA） antibody in chronic rejection after renal transplantation. Methods Immunofluorescence assay was performed to detect anti- endothelial cell antibody, and enzyme linked immunosorbent assay （ELISA）was performed to determine HLA antibody in the sera of patients after renal transplantation. The levels of creatinine in sera of the patients were also determined. Result The average level of creatinine was （ 116.3 ± 5.6 ） μmol/L in the patients with positive anti-HLA antibody. The average level of creatinine was （ 114.6 ± 4.7 ） μmol/L in the patients with positive anti-endothelial cell antibody after renal transplantation. The median level of creatinine was 131.2 μmol/L in the patients with both positive antibodies, and the quartile was 13.6 μmol/L. The levels of creatinine were significantly different between these two groups in statistical（P = 0.000）. Conclusion Both anti-endothelial cell antibody and anti-HLA antibody could lead to deterioration of renal function in chronic re- jection reaction of renal transplant. The renal dysfunction was more serious when both anti-endothelial cell anti- body and anti-HLA antibody were generated during chronic renal allograft rejection.

关 键 词：肾移植 抗人类白细胞抗原抗体 抗内皮细胞抗体 慢性排斥反应 

分 类 号：R446.6[医药卫生—诊断学] R699.2[医药卫生—临床医学]