中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (44): 8225-8228.doi: 10.3969/j.issn.1673-8225.2011.44.015

• 肾移植 kidney transplantation • 上一篇    下一篇

初次等待肾移植患者产生群体反应性抗体的因素分析

武俊杰，贾保祥，田  野   

  1. 首都医科大学附属北京友谊医院肾移植研究室，北京市  100050
  • 收稿日期:2011-08-05 修回日期:2011-08-15 出版日期:2011-10-29 发布日期:2011-10-29
  • 作者简介:武俊杰，女，1961年生，北京市人，汉族，1987年北京大学毕业，主管技师，主要从事器官移植配型及其相关实验方面的研究。 wjj0037@sina.com
  • 基金资助:

    北京友谊医院科研启动基金资助项目(2009-24)。

Analysis of factors inducing panel reactive antibodies in patients waiting for first kidney transplantation

Wu Jun-jie, Jia Bao-xiang, Tian Ye   

  1. Department of Kidney Transplantation, Beijing Friendship Hospital, Capital Medical University Beijing   100050, China
  • Received:2011-08-05 Revised:2011-08-15 Online:2011-10-29 Published:2011-10-29
  • About author:Wu Jun-jie, Technician in charge, Department of Kidney Transplantation, Beijing Friendship Hospital, Capital Medical University Beijing 100050, China wjj0037@sina.com
  • Supported by:

    Scientific Research Foundation of Beijing Friendship Hospital, No.2009-24*

PDF

352

被引次数

12

摘要：

背景：移植前后群体反应性抗体的存在与否是影响移植肾存活率及肾功能的重要因素之一。
目的：分析研究初次等待肾移植手术的患者产生群体反应性抗体的因素。
方法：检测1 674例初次等待肾移植患者群体反应性抗体。根据患者肾移植前的输血史和妊娠史，将患者分单纯输血组(n=509)：输血均为全血，输血量为200 mL以上；单纯妊娠组(n=397)；输血+妊娠组(n=235)；未输血未妊娠组(n=533)。
结果与结论：初次等待肾移植的患者中，群体反应性抗体阳性患者单纯输血组88例，阳性率为17.29%(88/509)；单纯妊娠组33例，阳性率8.31%(33/397)；输血+妊娠组64例，阳性率27.23%(64/235)。结果提示，单纯妊娠导致群体反应性抗体产生的概率较低，其阳性率并不随着妊娠次数的增加而增加；其次是输血的的影响，女性患者移植前输血产生群体反应性抗体的概率高于男性；既输血又妊娠的患者群体反应性抗体产生概率大于单纯输血或单纯妊娠患者；既未输血又未妊娠的患者一般不会产生群体反应性抗体。

关键词: 群体反应性抗体, 肾移植, 输血, 妊娠, 排斥反应

Abstract:

BACKGROUND: It has been suggested that panel reactive antibodies (PRA) levels are strongly correlated with acute rejection episodes. The positive PRA, either from pre- or post- transplant, is one of the important predictors of renal allograft function and survival.
OBJECTIVE: To characterize the factors inducing PRA sensitivity among uremia patients waiting for first kidney transplantation.
METHODS: PRA tests were performed in 1674 uremia patients waiting for their first kidney transplantation. They were divided into four groups, according to their history of transfusion and pregnancy. Group A: 509 patients with mere transfusion history; group B: 397 patients with mere pregnant history; group C: 235 patients with both transfusion and pregnant history; group D: 533 patients with neither transfusion nor pregnancy history.
RESULTS AND CONCLUSION: PRA positive rate was 17.29% (88/509), 8.31% (33/397), 27.23% (64/235) in group A, group B, and group C, respectively. No PRA positive rate was shown in group D. These findings suggest that the sensitizing effect of pregnancy alone on PRA level is comparatively low and is not increased along with the number of pregnancies. The transfusion factor comes in the second lowest effect. PRA positive rate is statistically significant higher in females in the transfusion group. Group C shows significantly higher PRA level, compared with either group A or group B. The patients with neither transfusion nor pregnancy history generally will not produce PRA.

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