群体反应性抗体对肾移植后人肾存活率影响临床分析.docVIP

群体反应性抗体对肾移植后人肾存活率影响临床分析 　　[摘要] 目的 回顾性调查群体反应性抗体（PRA）对肾移植术后1、3、5年人/肾存活率的影响。 方法 纳入北京军区第二八一医院2000年1月～2012年3月肾移植受者469例，采用酶联免疫吸附法（ELISA）检测受者移植前PRA水平，以PRA≤10%为阴性结果，10%40%为高度致敏，并对1、3、5年人/肾存活率进行统计。 结果 469例肾移植受者中，PRA阴性349例（阴性组），PRA阳性120例（阳性组），其中Ⅰ类抗体阳性66例，Ⅱ类抗体阳性31例，23例同时存在Ⅰ类和Ⅱ类抗体。术前PRA阴性组与阳性组1、3、5年人存活率分别为98.3%、90.9%、80.7%和93.3%、82.9%、62.9%；1、3、5年肾存活率分别为96.8%、87.9%、75.9%和86.7%、76.1%、50.5%，二组相比1、3、5年人/肾存活率均差异有统计学意义（P 0.05）；中度致敏组的1、3、5年人/肾存活率与阴性组比较，差异有统计学意义（P 　　[关键词] 移植；群体反应性抗体；存活率 　　[中图分类号] R617 [文献标识码] A [文章编号] 1673-7210（2014）02（a）-0058-04 　　Analysis of patient/graft survival rate of renal transplant recipients for panel reactive antibodies 　　TUO Ya1 BAI Jinxiang2 GUAN Xue3 　　1.Department of Urology， the 281st Hospital of Beijing Military Area Command， Hebei Province， Qinhuangdao 066100， China； 2.Department of Special Diagnosis， the 281st Hospital of Beijing Military Area Command， Hebei Province， Qinhuangdao 066100， China； 3.Department of Statistics， the 281st Hospital of Beijing Military Area Command， Hebei Province， Qinhuangdao 066100， China 　　[Abstract] Objective To retrospectively analyze the patient/graft survival rate of renal transplant recipients for panel reactive antibodies （PRA） in 1， 3， 5 years. Methods The patients received renal transplantations at the 281st Hospital of Beijing Military Area Command from January 2000 to March 2012 were included. Renal transplant recipients were preoperatively tested by enzyme linked immunosorbent assay （ELISA） with Lambda antigen tray （LAT）. According to the PRA level， the recipients were divided into negative group （PRA≤10%） and positive group （PRA10%）， and 3 subgroups with 10%40% （highly sensitive group）. Statistical survival rate of patient/graft in 1， 3， 5 years were analyzed. Results In the renal allograft recipent of the 469 case， the PRA nogative were 349 cases. The positive were 120 cases （34.4%）. Type Ⅰ antibody positive were 66 case， type Ⅱ antibody were 31 case， Ⅰ and Ⅱ were 23 cases in the sometime. In PRA neg