中华肾脏病杂志
中華腎髒病雜誌
중화신장병잡지
2013年
5期
321-325
,共5页
吴萍萍%金娟%王宇成%王霞月%陈江华
吳萍萍%金娟%王宇成%王霞月%陳江華
오평평%금연%왕우성%왕하월%진강화
肾移植%HLA抗原%移植物排斥
腎移植%HLA抗原%移植物排斥
신이식%HLA항원%이식물배척
Kidney transplantation%HLA antigens%Graft rejection
目的 比较ELISA法和LABScreen法检测HLA抗体结果的差异性,并分析两者对移植肾排斥的影响.方法 选取2008年11月至2009年12月期间在本科做肾移植和随访发现肌酐异常并且有肾穿记录怀疑移植肾排斥或者临界改变的患者,用莱姆德抗原板(LAT)和混合抗原板(LAT-MIX)通过ELISA方法检测HLA抗体,并与LABScreen技术检测的HLA抗体结果比较,研究两种方法对肾移植排斥检测结果的差异.结果 共277例患者被纳入研究,其中新移植230例,随访47例,术前HLA抗体阳性病例ELISA法为27例(9.7％),LABScreen法为145例(52.3％).其中ELISA法阴性而LABScreen法阳性的病例为118例(42.6％),ELISA法阳性的病例LABScreen法均阳性.未出现LABScreen法阴性而ELISA法阳性的病例,LABScreen法阳性而ELISA阴性的118个病例中,术后出现移植肾排斥的病例为41例(34.7％).两者均阴性的132个病例中,出现术后移植肾排斥的病例为24例(18.2％)(P=0.003).排斥组术后两周HLA抗体荧光强度不低于术前的占31％,而在非排斥组,术后两周HLA抗体荧光强度不低于术前的比例仅占12.8％ (P＜ 0.01).结论 LABScreen法在对HLA抗体检出率及敏感性上远高于ELISA法,并与移植肾排斥密切相关.
目的 比較ELISA法和LABScreen法檢測HLA抗體結果的差異性,併分析兩者對移植腎排斥的影響.方法 選取2008年11月至2009年12月期間在本科做腎移植和隨訪髮現肌酐異常併且有腎穿記錄懷疑移植腎排斥或者臨界改變的患者,用萊姆德抗原闆(LAT)和混閤抗原闆(LAT-MIX)通過ELISA方法檢測HLA抗體,併與LABScreen技術檢測的HLA抗體結果比較,研究兩種方法對腎移植排斥檢測結果的差異.結果 共277例患者被納入研究,其中新移植230例,隨訪47例,術前HLA抗體暘性病例ELISA法為27例(9.7％),LABScreen法為145例(52.3％).其中ELISA法陰性而LABScreen法暘性的病例為118例(42.6％),ELISA法暘性的病例LABScreen法均暘性.未齣現LABScreen法陰性而ELISA法暘性的病例,LABScreen法暘性而ELISA陰性的118箇病例中,術後齣現移植腎排斥的病例為41例(34.7％).兩者均陰性的132箇病例中,齣現術後移植腎排斥的病例為24例(18.2％)(P=0.003).排斥組術後兩週HLA抗體熒光彊度不低于術前的佔31％,而在非排斥組,術後兩週HLA抗體熒光彊度不低于術前的比例僅佔12.8％ (P＜ 0.01).結論 LABScreen法在對HLA抗體檢齣率及敏感性上遠高于ELISA法,併與移植腎排斥密切相關.
목적 비교ELISA법화LABScreen법검측HLA항체결과적차이성,병분석량자대이식신배척적영향.방법 선취2008년11월지2009년12월기간재본과주신이식화수방발현기항이상병차유신천기록부의이식신배척혹자림계개변적환자,용래모덕항원판(LAT)화혼합항원판(LAT-MIX)통과ELISA방법검측HLA항체,병여LABScreen기술검측적HLA항체결과비교,연구량충방법대신이식배척검측결과적차이.결과 공277례환자피납입연구,기중신이식230례,수방47례,술전HLA항체양성병례ELISA법위27례(9.7％),LABScreen법위145례(52.3％).기중ELISA법음성이LABScreen법양성적병례위118례(42.6％),ELISA법양성적병례LABScreen법균양성.미출현LABScreen법음성이ELISA법양성적병례,LABScreen법양성이ELISA음성적118개병례중,술후출현이식신배척적병례위41례(34.7％).량자균음성적132개병례중,출현술후이식신배척적병례위24례(18.2％)(P=0.003).배척조술후량주HLA항체형광강도불저우술전적점31％,이재비배척조,술후량주HLA항체형광강도불저우술전적비례부점12.8％ (P＜ 0.01).결론 LABScreen법재대HLA항체검출솔급민감성상원고우ELISA법,병여이식신배척밀절상관.
Objective To compare the difference of ELISA and LABScreen in detecting HLA antibodies and evaluate their effects on allograft rejection.Methods Consecutive patients undergoing kidney transplantion from November,2008 to December,2009 in the First Affiliated Hospital and the following up patients during the same period,with abnormal Scr who had completed kidney biopsies,were included in this study.Patients' HLA antibodies were detected by ELISA (Lambda antigen tray,LATTM) and LABScreen Mix Beads (LABScreen MIX,One Lambda,Canoga Park,CA,USA) or LABScreen Single antigen beads (LABScreenTM single antigen beads,One Lambda,Canoga Park,CA,USA).Patients' Scr were also detected at different time potints.Results There were 277 patietns included.Among them 145 (52.3％) cases were HLA antibody positive detected by LABScreen,which including 118 cases ELISA negative but LABScreen positive,and 27 cases both ELISA and LABScreen positive.No case was ELISA positive but LABScreen negative.Among 118 cases which were LABScreen positive but ELISA negative,41 (34.7％) cases happened acute or chronic rejection.However,only 24 cases happened rejection in 132 double negative cases (18.2％,P =0.003).There were 31％ patients in rejection group while only 12.8％ patients (P=0.01) in non-rejection group whose HLA antibody fluorescence intensity detected by LABScreen single antigen beads still increased two weeks after transplantation.Conclusion LABScreen is more sensitive than ELISA in detecting HLA antibodies,and its result highly correlates with the incidence of allograft rejection.
