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山东大学学报(医学版) ›› 2009, Vol. 47 ›› Issue (12): 74-77.

• 论文 • 上一篇    下一篇

肾移植术后新生HLA抗体和MICA抗体对移植肾功能的损伤作用

彭志国1,田军1,扈煜2,张鲁伟1,崔先泉1,毕正3,鲜万华1,孙怀斌1,李恩刚1   

  1. 山东大学齐鲁医院 1. 血液净化肾移植科, 2. 血液科, 3. 检验科, 济南 250012
  • 收稿日期:2009-01-21 出版日期:2009-12-16 发布日期:2009-12-16
  • 通讯作者: 田军(1963- ),男,教授,主要从事肾移植及血液净化的基础和临床研究。 Email:t3j6s8@sina.com
  • 作者简介:彭志国(1977- ),男,硕士研究生,主要从事肾移植及血液净化的基础和临床研究。

Impact of posttransplant development of HLA antibodies and MICA antibodies on renal allograft function

PENG Zhiguo 1, TIAN Jun 1, HU Yu 2 , ZHANG Luwei 1, CUI Xianquan 1,BI Zheng 3 , XIAN Wanhua 1 , SUN Huaibin 1, LI Engang 1   

  • Received:2009-01-21 Online:2009-12-16 Published:2009-12-16

摘要:

目的研究肾移植术后新生人类白细胞抗原(HLA) 抗体及主要组织相容性I类相关链A抗原(MICA)抗体的产生对移植肾功能的损伤作用。方法采用免疫磁珠流式细胞仪液相芯片技术检测96例肾移植患者HLA及MICA抗体。根据检测结果,将患者分为HLA抗体阳性组(HLA+)、MICA抗体阳性组(MICA+)、以及HLA、MICA抗体阴性组(HLA/MICA),观察并比较各组不良免疫事件的发生率。再根据有无急性排斥(AR),将患者分为排斥组(AR+)和非排斥(AR)组,观察HLA抗体、MICA抗体对移植肾功能的影响。结果HLA+组急性排  斥反应发生率高于HLA/MICA组(43.5% vs 11.7%,P<0.05);MICA+组急性排斥反应发生率与HLA/MICA组比较差异无统计学意义(15.3% vs 11.7%,P>0.05);AR+组中,HLA+患者术后1、3、6和12个月时血清肌酐水平高于HLA/MICA患者, MICA+患者在术后1、3月时血肌酐水平高于抗体阴性患者;AR组中,HLA+患者术后6、12个月血肌酐水平高于HLA/MICA患者;MICA+组在术后6个月及12个月的尿蛋白定量均值高于150?mg,并随时间逐渐升高。结论HLA抗体对移植肾功能的损伤作用表现为血清肌酐的升高以及与急性排斥反应的发生有关;MICA抗体对移植肾功能的损伤主要表现为尿蛋白定量的升高。

关键词: 肾移植;HLA抗体;MICA抗体;移植物排斥

Abstract:

To study the impact of post transplant development of human leucocyte antigen(HLA) antibodies and MHC class I chainrelated A antigen(MICA) antibodies on renal allograft function. MethodsPost transplant sera of 96 renal transplantation patients were tested by Luminex flow cytometry for HLA antibodies and MICA antibodies. According to the test results, patients were divided into the HLA antibodiespositive (HLA+) group, MICA antibodiespositive  (MICA+)  group, and HLA antibodies and MICA antibodiesnegative(HLA/MICA)group.  The incidence of adverse immune events was compared among these groups. According to having acute rejection (AR) or not, patients were divided into the AR+group and AR group, and the impacts of HLA antibodies and MICA antibodies on renal graft function were observed. ResultsThe AR incidence in the HLA+ group was higher than in the HLA/MICAgroups (43.5% vs 11.7%,P<0.05). There was no statistical significance in the AR episodes between the MICA+ group and the HLA/MICAgroups (15.3% vs 11.7%,P>0.05). Higher serum creatinine levels in the 1st, 3rd, 6th and 12th months after transplantation were evidenced in the HLA+ group with more AR episodes than in those who had AR but did not produce antibodies. In the MICA+ group with AR,months after transplantation were higher than in patients with AR but without antibodies. Urine protein quantitation in the MICA+ group in the 6th and 12th months after transplantation exceeded 150?mg and increased with time. ConclusionHLA antibodies play an important role in AR episodes after kidney transplantation and the renal allograft function could be damaged by HLA antibodies. MICA antibodies may result in an increase in urine protein quantitation for the kidney recipient and may damage renal allograft function.

Key words: Renal transplantation; Human leucocyte antigen antibodies; MHC class I chainrelated A antigen antibodies; Graft rejection

中图分类号: 

  • R392
[1] 刘洋,王月兰,宋秀梅. 聚乙烯亚胺介导水通道蛋白5基因表达载体体外转染的研究[J]. 山东大学学报(医学版), 2011, 49(8): 57-61.
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