心脏移植后早期排斥反应的影响因素  

Analysis of Influencing Factors of Early Rejection after Heart Transplantation

作　　者：帅莉 付晓野 韦杰[2] 马啸[1] 周律 康细林 SHUAI Li;FU Xiaoye;WEI Jie;MA Xiao;ZHOU Lv;KANG Xilin(Dept,of Blood Transfusion,Yan'an Hospital Affiliated to Kunming Medical University,Kunming Yunnan 650051,China;Dept,of Heart Vascular Surgery,Yan'an Hospital Affiliated to Kunming Medical University,Kunming Yunnan 650051,China)

机构地区：[1]昆明医科大学附属延安医院输血科,云南昆明650051 [2]昆明医科大学附属延安医院心脏大血管外科,云南昆明650051

出　　处：《昆明医科大学学报》2022年第1期129-132,共4页Journal of Kunming Medical University

基　　金：云南省科技厅-昆明医科大学应用基础研究联合专项基金资助项目(2018FE001-276)。

摘　　要：目的探讨HLA配型与心脏移植患者术后急性排斥反应的关系。方法纳入2003年5月至2021年1月,在昆明医科大学附属延安医院做心脏移植术的24例患者作为研究对象,对移植术后3至12个月的患者早期疗效和排斥反应进行随访观察。使用PCR-SSP方法对供受者进行HLA分型。采用SPSS Statistics 17.0软件的Forward Stepwise(Conditional)方法进行二分类逻辑回归,分析心脏移植患者急性排斥的影响因素。结果对24例心脏移植供受者之间的HLA六抗原配型,在错配数3至4个抗原以内与错配数5或6个抗原相比,排异反应率低差异具有统计学意义(P<0.05)。在2例按照ABO血型相容原则,O型供体心脏移植给A型受体的病例中,2例早期均发生了排斥反应,而在7例性别不同的供受者中有3例早期有排异反应。结论多方面因素会造成心脏移植的排斥反应,而HLA六抗原错配数是心脏移植排斥反应的重要因素之一。Objective To analyze and explore the relationship between HLA matching and acute rejection after the heart transplantation.Methods From May 2003 to January 2021,24 patients who underwent heart transplantation in Yan’an Hospital affiliated to Kunming Medical University were included as the research subjects.Follow-up observations were made on the early curative effect and rejection of patients 3 to 12 months after the transplantation.HLA typing was performed by PCR-SSP and the forward stepwise(conditional)method of SPSS statistics 17.0 software was used for binary logistic regression to analyze the influencing factors of acute rejection in heart transplantation patients.Results For the HLA six-antigen matching between the 24 donors and recipients of heart transplantation,the rejection rate was lower when the number of mismatches was less than 3 to 4 compared with the number of mismatches of 5 or 6 antigens(P<0.05)The difference was statistically significant.According to the principle of ABO blood group compatibility,in 2 cases of type O donor heart transplantation to type A recipients,both of the 2 cases had the early rejection,while 3 of the 7 donors and recipients of different genders had the early rejection.Conclusion Many factors can cause the rejection of heart transplantation,and the number of HLA six antigen mismatches is one of the important factors for the rejection of heart transplantation.

关 键 词：心脏移植 HLA配型 血型 性别 移植排斥 

分 类 号：R4[医药卫生—临床医学]