再次肾移植患者术后PRA与血肌酐的研究.docVIP

再次肾移植患者术后PRA与血肌酐的研究 　　作者：贾保祥,徐秀红,田野　　作者单位：北京友谊医院科研启动基金资助项目(编号：200924) 100050 北京市，首都医科大学附属北京友谊医院泌尿科 　　【摘要】 目的 研究再次肾移植患者移植术后群体反应性抗体(PRA)与肾功能之间的关系。方法 对35例目前能够追踪到的再次肾移植患者进行PRA和血肌酐的分析。PRA检测采用美国莱姆德公司抗原筛选板和美国GTI公司提供的ELISA筛选HLAⅠ类、Ⅱ类混合抗原板，鉴定抗体类型采用采用美国One lanmbda公司鉴定抗原板(LAT1240)。血肌酐检测数据由检验科提供。结果 35例再次肾移植术后患者中，PRA阴性/血肌酐水平正常17例(48.57%);PRA阴性/血肌酐水平≥130 Μmol/L 4例(11.44%)。PRA阳性/血肌酐正常8例(22.86%)，其中抗HLAⅠ类抗体阳性患者1例，其余为抗HLAⅡ类抗体。PRA阳性/血肌酐水平≥130 Μmol/L 6例(17.14%)，其中抗HLAⅠ+Ⅱ类抗体阳性3例，抗HLAⅠ类抗体阳性1例，抗HLAⅡ类抗体阳性2例。在3例抗HLAⅠ+Ⅱ类抗体阳性中的血肌酐水平分别为740 Μmol/L、400 Μmol/L和131 Μmol/L。1例抗HLAⅠ类抗体阳性的血肌酐水平为390 Μmol/L。2例抗HLAⅡ类抗体阳性的血肌酐水平分别为194 Μmol/L 和170 Μmol/L。结论 再次肾移植患者中PRA阳性和阴性/血肌酐正常的肾移植患者多于PRA阴性和PRA阳性/血肌酐水平不正常的患者。抗HLAⅡ类抗体对移植肾功能的影响小于抗HLA1和Ⅰ+Ⅱ类抗体。 　　【关键词】 再次肾移植;群体反应性抗体;血肌酐 　　Study on the relationship between posttransplantation PRA and serum creatinine in secondary renal transplantation patients JIA Baoxiang, XU Xiuhong,TIAN Ye. Beijing Friendship Hospital Affiliated to Capital University of Medical Sciences, Beijing 100050,China 　　【Abstract】 Objective To investigate the relationship between posttransplantation PRA and renal fuction in secondary renal transplantation patients. Methods The serum samples were collected from 35 secondary renal transplantation patients and were tested by ELISAPRA,serum creatinine levels offered by clinical laboratory were analyzed at the same time. Results 48.57%(17/35) of patients showed PRA negative/creatinine levels were normal; 11.44%(4/35) of patients showed PRA negative/creatinine levels≥130Μmol/L; 22.86%(8/35)of patients showed PRA positive/creatinine levels normal, with HLAIantibody positive in 1 patient, HLAⅡ antibody positive in the other patients; 17.14%(6/35) of patients showed PRA positive/creatinine levels≥130Μmol/L, with both HLAI and HLAⅡ antibody positive in 3 patients(creatinine levels: 740Μmol/L,400Μmol/L and 131Μmol/L respectively), and HLAⅠantibody positive in 1 patient(creatinine levels: 390Μmol/L), HLAⅡ antibody positive in