HLA高分辨等位基因与骨髓移植受者HCMV抗原血症研究

目的 分析HLA高分辨等位基因与骨髓移植术后HCMVpp65抗原血症的相关性.方法 选取2009年2月至2010年10月在我院行骨髓移植术患者48例;采用免疫组化方法检测患者HCMVpp65,采用直接测序分型方法（PCR-SBT）检测患者HLA-A＊1101、HLA-A＊0201、HLA-A＊2402、HLA-B＊4001、HLA-DRB1＊0901五个高分辨等位基因.结果 ①48例骨髓移植术后患者HCMV感染率100％;②HLA-A＊1101、HLA-A＊0201、HLA-A＊2402、HLA-B＊ 4001等位基因阳性率在pp65抗原血症12例低感染组和36例高感染组中比较没有统计学意义（P＞0.05）,其阳性率HLA-A＊1101为33.3％ （8/24）和20.8％ （15/72）、HLA-A＊0201为4.2％ （1/24）和13.9％ （10/72）、HLA-A＊ 2402为12.5％ （3/24）和19.4％ （14/72）、HLA-B＊ 4001 16.7％ （4/24）和12.5％ （9/72）;③HLA-DRB1＊0901等位基因阳性率在pp65抗原血症12例低感染组和36例高感染组中比较有统计学意义（P =0.048）,其阳性率为4.2％ （1/24）和19.4％ （14/72）;④HLA-DRB1＊0901组患者pp65抗原血症高于HLA-A＊2402组（P =0.007）和HLA-A＊1101组患者（P=0.028）,HLA-A＊0201组患者pp65抗原血症高于HLA-A＊2402组患者（P=0.02）,其他高分辨等位基因组之间pp65抗原血症差异没有统计学意义（P＞0.05）.结论 HLA-DRB1＊0901等位基因可能与骨髓移植术后患者发生高HCMVpp65抗原血症有关;HLA-A＊2402等位基因可能与骨髓移植术后患者发生低HCMVpp65抗原血症有关.

The study on high-resolution HLA and human cytomegalovirus (HCMV) viremia in bone marrow transplantation recipients

Objective To study the correlation between high-resolution HLA-A * 1101,HLA-A * 0201,HLA-A * 2402,HLA-B * 4001,HLA-DRB1 * 0901 with HCMV pp65 antigenemia after bone marrow transplantation (BMT) in China.Methods 48 recipients doing BMT during 2009.2-2010.10 were selected in my hospital; HCMV pp65 was detected by ELISA or immunohistochemical methods.The frequency of HLA-A * 1101,HLA-A * 0201,HLA-A * 2402,HLA-B * 4001,HLA-DRB1 * 0901 alleles were determined by Polymerase chain reaction-sequence based typing( PCR - SBT).Results ① The BMT recipients were HCMV pp65 antigenic positive( 100％ ) ; ② The positive rate of HLA-A * 1101,HLA-A * 0201,HLA-A *2402,HLA-B * 4001 showed no obvious difference between 12 lower antigenemia group and 36 higher antigenemia group,the positive rate: HLA-A * 1101 were 33.3％ (8/24)and 20.8％ (15/72),HLA-A * 0201 were 4.2％ (1/24) and 13.9％ ( 10/72),HLA-A * 2402 were 12.5％ (3/24) and 19.4％ ( 14/72),HLA-B * 4001 were 16.7％ (4/24) and 12.5％ ( 9/72 ) ; ③ HLA-DRB1 * 0901 positive rate in higher antigenemia group was higher than the lower ( P =0.048 ),the positive rate were 4.2％ ( 1/24 ) and 19.4％ (14/72) ;④ HLA-DRB1 * 0901 recipients were higher pp65 antigenemia than HLA-A * 2402 recipients (P=0.007) and HLA-A * 1101 recipients (P =0.028),HLA-A * 0201 recipients were higher pp65 antigenemia than HLA-A * 2402 ( P =0.02),the pp65 antigenemia showed no obvious difference among the rest of high-resolution HLA groups (P ＞ 0.05).Conclusion HLA-DRB1 * 0901 alleles might be correlated with BMT recipients happened higher pp65 antigenemia,HLA-A * 2402 alleles might be correlated with BMT recipients happened lower pp65 antigenemia.