再次肾移植患者术后PRA与血肌酐的研究

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Onelanmbda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≥130μmol/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≥130μmol/L6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740μmol/L、400μmol/L和131μmol/L。1例抗HLA-Ⅰ类抗体阳性的血肌酐水平为390μmol/L。2例抗HLA-Ⅱ类抗体阳性的血肌酐水平分别为194μmol/L和170μmol/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。

Study on the relationship between post-transplantation PRA and serum creatinine in secondary renal transplantation patients

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 2 patients（creatinine levels： 194μmol/L and 170μmol/L respectively）.Conclusion There are more patients who show that PRA positive and negative/creatinine normal,as compared with those show that PRA negative and positive/creatinine abnormal.HLA-Ⅱantibody affects renal function secondarily,but which is not as important as HLA-Ⅰand HLA-Ⅰ＋Ⅱ antibody.