论文部分内容阅读
目的对肾移植受者术前群体反应性抗体(PRA)增高的检测结果进行调查,分析其致敏因素及抗体分布,为临床肾移植手术提供参考依据,以提高移植物的存活时间。方法用酶联免疫吸附实验(ELISA方法)检测2005—2008年728名肾移植受者术前的PRA共计,对高PRA患者进行致敏相关因素及HLA抗体分析。结果135例标本出现不同程度的增高,PRA增高水平自10%—90%不等。移植后的患者易产生PRA抗体,不同性别PRA增高的原因存在差异,男性以输血致敏为主,女性以输血、妊娠为主。135名高PRA患者中59名存在Ⅰ类HLA-IgG抗体,28例存在Ⅱ类HLA-IgG抗体,48例同时存在Ⅰ类和Ⅱ类HLA-IgG抗体。检出HLA-A、B、Cw、DR、DQ抗体分别为18、22、8、15和8种,其中以HLA-A11、A23、Bw6、DR52、DR53等位基因产物的抗体频率较高,频率分布与HLA抗原频率分布不尽一致。结论移植史、输血史及妊娠史是致敏因素,这些致敏因素有协同作用,可提高致敏率。某些HLA抗原更易使机体产生抗体。
OBJECTIVE: To investigate the detection results of preoperative PRA in renal transplant recipients and to analyze the sensitizing factors and antibody distribution, so as to provide a reference for clinical renal transplantation in order to improve the survival time of the graft. Methods Preoperative PRA total of 728 kidney transplant recipients from 2005 to 2008 was detected by enzyme-linked immunosorbent assay (ELISA), and related factors and HLA antibody analysis of patients with high PRA were performed. Results 135 cases increased to varying degrees, PRA increased from 10% to 90% range. PRA antibody is easy to produce in patients after transplantation. There are differences in the reasons for the increase of PRA in different sexes. Male is mainly caused by blood transfusion and blood transfusion and pregnancy are the main factors. Of the 135 patients with high PRA, 59 had class I HLA-IgG antibodies, 28 had class II HLA-IgG antibodies, and 48 had both class I and class II HLA-IgG antibodies. The antibodies against HLA-A, B, Cw, DR and DQ were detected as 18, 22, 8, 15 and 8 respectively. The frequency of HLA-A11, A23, Bw6, DR52 and DR53 allele products was high, Frequency distribution and HLA antigen frequency distribution are not the same. Conclusion Transplant history, blood transfusion history and pregnancy history are sensitizing factors. These sensitizing factors have synergistic effects and can improve the sensitization rate. Some HLA antigens more easily make the body produce antibodies.