肾移植术后天然抗体对受者预后影响的相关性研究  

A retrospective study on the effect of natural antibody on the prognosis of recipients after renal transplantation

作　　者：刘伟[1] 赵杰[2] 宋广平[1] 刘伟 赵一贺[1] 李代红 Liu wei;Zhao jie;Song Guangping;Liu wei;Zhao Yihe;Li Daihong(Departments of Blood Transfusion,Tianjin First Central Hospital,Tianjin 300192,China;Departments of Transplantation Surgery,Tianjin First Central Hospital,Tianjin 300192,China)

机构地区：[1]天津市第一中心医院输血科,天津300192 [2]天津市第一中心医院移植外科,天津300192

出　　处：《实用器官移植电子杂志》2020年第5期375-379,共5页Practical Journal of Organ Transplantation(Electronic Version)

基　　金：天津市第一中心医院临床试验项目(LC2018028)。

摘　　要：目的探讨肾移植术后天然抗体(natural antibodies,Nabs)对移植肾长期存活与排斥反应的影响。方法回顾性分析44例发生抗体介导排斥反应肾移植受者的病例资料,用酶联免疫吸附试验(enzyme linked immunosorbent assay,ELISA)检测Nabs,根据Nabs的产生情况将受者分成Nabs+组(10例)和Nabs-组(34例),分别记录受者移植术后移植物存活情况,并同时观察发生排斥反应时各组肾功能和移植肾病理表现的差异。结果Nabs+组移植术后移植物存活率明显低于Nabs-组,差异有统计学意义(P=0.044)。移植后Nabs也与肾活检标本中移植物损伤的组织学征象的平均Banff评分增加相关。Nabs+组与Nab-组相比,肾小球滤过率估计值(estimated glomerular filtration rate,eGFR)有所下降,但差异无显著性(P>0.05)。结论Nabs与移植肾损伤及肾功能衰竭相关,从而提示Nabs可能参与了排斥反应的免疫机制。Objective To investigate the effect of natural antibodies(Nabs)on long-term survival and rejection after renal transplantation.Methods The clinical data of 44 renal transplant recipients with antibodymediated rejection were studied retrospectively.Nabs was detected by enzyme linked immunosorbent assay(ELISA)method.According to the production of Nabs,the recipients were divided into Nabs+group(n=10)and Nabs-group(n=34).The graft survival after transplantation was recorded,and the differences of renal function and pathology of each group during rejection were observed at the same time.Results The graft survival rate in Nabs+group was significantly lower than that in Nabs-group(P=0.044).Post-transplant Nabs was also associated with an increase in the average Banff score of histological signs of graft injury in renal biopsy specimens.Estimated glomerular filtration rate(eGFR)in Nabs+group was lower than that in Nab-group,but there was no significant difference(P>0.05).Conclusion Nabs is associated with renal allograft injury and renal failure,suggesting that Nabs may be involved in the mechanism of immune rejection.

关 键 词：肾移植 天然抗体 抗体介导排斥反应 移植物损伤 

分 类 号：R699.2[医药卫生—泌尿科学]