HLA-DRB_1基因配型与高危角膜移植排斥关系的回顾性研究

目的　评价 HL A基因配型在减少高危角膜移植免疫排斥反应中的作用。方法　对 91例高危穿透性角膜移植病例 ,术后双盲法进行供受体 HL A - DRB1 基因分型和临床观察 ,随访 12～ 2 6 mo,对其基因配型情况和术后排斥反应的关系进行回顾性分析。结果　 91例患者中 6 1例随访资料完整。其中 16例供受体有 1个基因位点相符 ,在这些配型良好的病例中 ,5例 (31.2 4% )发生免疫排斥反应 ,但随访期间无植片混浊 ;45例配型不好的患者中 ,术后 2 3例 (5 1.11% )发生免疫排斥反应 ,其中 5例发生了植片混浊。结论　 HL A- DRB1基因配型未能显著减少角膜移植术后的免疫排斥反应

Retrospective study on efficacy of HLA-DRB_1 genetic typing in high risk corneal transplantation

Objective To evaluate the efficacy of the use of HLA DRB 1 genetic typing in high risk corneal transplantation.Methods Total of 91 high risk penetrating keratoplasty(PKP) patients were enrolled in this double masked study. HLA DRB 1 genetic typing was performed for both donors and recipients immediately after PKP, and were followed up for 12 to 26 months using a double masked design. The correlation between the graft rejection and HLA DRB 1 matching was analysed retrospectively.Results Sixty one of 91 cases had complete follow up data. Only 5 of 16 (31.24%)well matched patients (1 gene loci matched)had graft rejection during the study period with no grafts failure. In 45 poor matched patients, 23 of 45 (51.11%)had more than one episode of rejection with 5 grafts failure.Conclusion Good HLA DRB 1 matching did not result in the reduction of the corneal graft rejection.