尿毒症患者群体反应性抗体的种类与频率

目的研究尿毒症患者群体反应性抗体（PRA）的种类与频率。方法分析2008-2013年本院门诊及住院的2727例尿毒症患者PRA检测结果,血清样本以ELISA方法检测HLA I类、Ⅱ类混合抗原板。将检测结果分为阴性组（PRA〈10%）和阳性组（PRA≥10%）,采用SPSS21.0软件分析不同性别、年龄组患者PRA阳性率的差异。结果2727例患者中,PRA阳性组366例,PRA阴性组2361例,阳性率13.4%。其中,男性1840例,阳性率为10.1%（186/1840）,女性887例,阳性率为20.3%（180/887）,男女阳性率差异有统计学意义（χ^2=53.42,P〈0.01）;各年龄组阳性率比较,结果显示少年组为4.8%（4/83）,青年组为10.0%（85/854）,中年组为16.1%（268/1660）,老年组为6.9%（9/130）,各年龄组的阳性率差异有统计学意义（χ^2=29.44,P〈0.01）。ELISA方法能检出HLA-A、B、CW、DR、DQ位点特异性抗体20种、27种、5种、13种和7种。各位点出现频率较高的抗体种类分别是A2、A25、A23、A24、A66;B7、B13、B57、B44、B60;CW4、CW 6、CW 10、CW 7、CW8;DR11、DR1、DR7、DR9、DR12;DQ6、DQ5、DQ7、DQ8、DQ2,频率分布与中国人群HLA抗原频率分布不尽一致。结论尿毒症患者PRA阳性率女性显著高于男性,不同年龄组阳性率也有显著差异,以少年组最低,中年组最高。针对不同等位基因的HLA抗体产生频率不同。

The Type and Frequency of Panel Reactive Antibody in Uremic Patients

Objective To investigate the type and frequency of panel reactive antibody in uremic patients.Methods Panel reactive antibody of anti-HLA-I,II in serum were detected using ELISA method,and the PRA results from a total of 2727 uremic patients from 2008 to 2013 were analyzed.According to the test results of panel reactive antibody,the cases were divided into PRA-negative group （PRA〈10%）and PRA-positive group（PRA≥10%）.The difference of PRA positive rate of different age,gender was analyzed by SPSS2 1 .0 software;and the type and frequency of panel re-active antibody of anti-HLA-I andⅡ were also observed.Results Of the 2727 patients,2361 cases were PRA-negative and 366 cases were PRA-positive.The positive rates of male and female cases were 10.1% and 20.3% respectively, with statistical significance.（χ^2=53.42,P〈0.01）.The positive rate of PRA in juvenile group,young group,middle age group and old group was 4.8%,10.0%,16.1% and 6.9%,respectively.The difference of that was statistically sig-nificant（χ^2=29.44,P〈0.01）.Furthermore,multiple types of specific antibodies against HLA-A（20）,B（27）,CW（5）, DR（13）and DQ（7）were determined by ELISA method.Some types of the antibodies presented higher frequencies,such as anti-HLA-A2,A25,A23,A24 and A66;B7,B13,B57,B44 and B60;CW4,CW 6,CW 10,CW 7 and CW8;DR11, DR1,DR7,DR9 and DR12;DQ6,DQ5,DQ7,DQ8 and DQ2.The frequency of antibody was somewhat different from that of HLA antigen.Conclusion The positive rate of PRA was higher in female than that in male.The difference of positive rate of all ages’patients was statistically significant,the j uvenile group was the lowest and middle age group was the highest.These high frequencies of anti-HLA-I,II antibodies were somewhat different from the distribution of HLA antigens in Chinese population.