肾移植患者尿中HLA-DR抗原mRNA表达的检测及其意义  

Expression of HLA-DR mRNA in urenary sediment of renal allograft

作　　者：张志宏 付耀文[2] 韩文科 许昕 杨建林 厉将斌 李彦峰 郭应禄 

机构地区：[1]北京大学医学部第一医院泌尿外科北京大学泌尿外科研究所,北京100034 [2]吉林大学附属中日联谊医院泌尿外科

出　　处：《肾脏病与透析肾移植杂志》2002年第5期423-426,共4页Chinese Journal of Nephrology,Dialysis & Transplantation

基　　金：国家自然科学基金资助 (NO :3 0 2 712 96)

摘　　要：目的 :研究肾移植术后患者尿沉渣中的细胞抗原 ,特别是在排斥反应时的变化。　 方法 :以肾移植患者 5 6例为研究对象 ,自尿中提取mRNA ,经逆转录获得cDNA ,利用RT PCR法对HLA DR抗原基因进行检测。　结果 :急性排斥反应 (AR ,n =18)组 :HLA DR基因 16例表达 ,2例无表达。慢性排斥反应 (CR ,n =12 )组 :HLA DR基因 2例表达 ,10例无表达。环孢霉素中毒 (CRA ,n =6 )组 :HLA DR基因 6例均无表达 ,正常移植肾组 (Normal,n=2 0 ) :HLA DR基因 1例表达 ,19例无表达。　 结论 :从肾移植患者尿沉渣中提取mRNA是可能的 ,HLA DR抗原基因mRNA在AR组病例的尿沉渣中高频率地表达 ,并且其表达与供体和受体HLA DR抗原错配无相关性 ,提示尿中HLAObjective:Over expression of HLA DR antigen is implicated in the process of renal allograft rejection.In this study,urinary sediments of renal allograft recipients were collected and mRNA expression of HLA DR antigen determined to explore its relevance with occurrence of acute or chronic rejection. Methodology:56 renal allograft recipients were involved in this study,including 18 with acute rejection,12 with chronic rejection,6 with cyclosporin A nephrotoxicity and 20 with stable functioning allograft. Results:In recipients with acute allograft rejection,16 of 18 were positive for the detection of HLA DR mRNA.In recipients with chronic allograft rejection,2 out of 12 were positive.And in 6 recipients with cyclosporin A nephrotoxicity,non were positive.In 20 recipients with stable functioning allograft,only one was positive for the detection.No correlation was found between the positive expression of HLA DR mRNA and the number of HLA typeing mismatches. Conclusion:Urinary sediment is feasible for the detection of HLA DR antigen expression in renal allograft recipients.Positive expression of HLA DR mRNA is correlated with the occurrence of both acute and chronic rejection,while not the case for cyclosporin A nephrotoxicity.

关 键 词：肾移植 尿 HLA-DR抗原 mRNA 检测 排斥反应 临床意义 

分 类 号：R699.2[医药卫生—泌尿科学]