山西医药杂志
山西醫藥雜誌
산서의약잡지
SHANXI MEDICAL JOURNAL
2014年
21期
2487-2490
,共4页
周文强%石炳毅%韩永%钱叶勇%蔡明%肖漓%王强%许晓光%黄海燕%王新颖%匡国杰%武洪文
週文彊%石炳毅%韓永%錢葉勇%蔡明%肖巑%王彊%許曉光%黃海燕%王新穎%劻國傑%武洪文
주문강%석병의%한영%전협용%채명%초리%왕강%허효광%황해연%왕신영%광국걸%무홍문
肾移植%移植物排斥%HLA抗体%MICA抗体
腎移植%移植物排斥%HLA抗體%MICA抗體
신이식%이식물배척%HLA항체%MICA항체
Kidney transplantation%Graft rejection%Anti-HLA antibody%Anti-MICA antibody
目的：探讨液态芯片技术（Luminex）检测移植肾受者围手术期发生急性抗体介导性排斥反应者抗人类白细胞抗原（HLA）抗体、抗主要组织相容性Ⅰ类相关链A位点（MICA）抗体水平与影响。方法选取我院器官移植研究所2008年1月至2013年6月肾移植术后围手术期患者106例为研究对象，采用Luminex技术检测接受同种异体肾移植手术并明确病理诊断肾围手术期急性抗体介导性排斥反应患者血清中抗HLA抗体、抗MICA抗体，并同步检测血肌酐、尿量及移植肾超声等临床指标。结果参照Banff2007标准组织病理学诊断移植肾超急性排斥反应2例，急性抗体介导性排斥反应15例，同时应用Luminex方法检测抗HLA抗体、抗MI-CA抗体水平，HLA抗体检测结果15例阳性，阳性率为88％（15/17），检出PRAⅠ类和Ⅱ类阳性率分别为47％（7/15）和53％（8/15）；MICA抗体2例阳性，阳性率为12％（2/17），其余89例其他病理类型检测未见抗HLA抗体、MICA抗体阳性，移植肾穿刺病理结果显示HLA抗体、抗MICA抗体阳性患者C4d沉积均为阳性。结论抗HLA抗体、抗MICA抗体可预测围手术期急性抗体介导性排斥反应发生及治疗效果，对于及时诊断及治疗排斥反应提供了一个重要指标，可影响移植肾的长期存活。
目的：探討液態芯片技術（Luminex）檢測移植腎受者圍手術期髮生急性抗體介導性排斥反應者抗人類白細胞抗原（HLA）抗體、抗主要組織相容性Ⅰ類相關鏈A位點（MICA）抗體水平與影響。方法選取我院器官移植研究所2008年1月至2013年6月腎移植術後圍手術期患者106例為研究對象，採用Luminex技術檢測接受同種異體腎移植手術併明確病理診斷腎圍手術期急性抗體介導性排斥反應患者血清中抗HLA抗體、抗MICA抗體，併同步檢測血肌酐、尿量及移植腎超聲等臨床指標。結果參照Banff2007標準組織病理學診斷移植腎超急性排斥反應2例，急性抗體介導性排斥反應15例，同時應用Luminex方法檢測抗HLA抗體、抗MI-CA抗體水平，HLA抗體檢測結果15例暘性，暘性率為88％（15/17），檢齣PRAⅠ類和Ⅱ類暘性率分彆為47％（7/15）和53％（8/15）；MICA抗體2例暘性，暘性率為12％（2/17），其餘89例其他病理類型檢測未見抗HLA抗體、MICA抗體暘性，移植腎穿刺病理結果顯示HLA抗體、抗MICA抗體暘性患者C4d沉積均為暘性。結論抗HLA抗體、抗MICA抗體可預測圍手術期急性抗體介導性排斥反應髮生及治療效果，對于及時診斷及治療排斥反應提供瞭一箇重要指標，可影響移植腎的長期存活。
목적：탐토액태심편기술（Luminex）검측이식신수자위수술기발생급성항체개도성배척반응자항인류백세포항원（HLA）항체、항주요조직상용성Ⅰ류상관련A위점（MICA）항체수평여영향。방법선취아원기관이식연구소2008년1월지2013년6월신이식술후위수술기환자106례위연구대상，채용Luminex기술검측접수동충이체신이식수술병명학병리진단신위수술기급성항체개도성배척반응환자혈청중항HLA항체、항MICA항체，병동보검측혈기항、뇨량급이식신초성등림상지표。결과삼조Banff2007표준조직병이학진단이식신초급성배척반응2례，급성항체개도성배척반응15례，동시응용Luminex방법검측항HLA항체、항MI-CA항체수평，HLA항체검측결과15례양성，양성솔위88％（15/17），검출PRAⅠ류화Ⅱ류양성솔분별위47％（7/15）화53％（8/15）；MICA항체2례양성，양성솔위12％（2/17），기여89례기타병리류형검측미견항HLA항체、MICA항체양성，이식신천자병리결과현시HLA항체、항MICA항체양성환자C4d침적균위양성。결론항HLA항체、항MICA항체가예측위수술기급성항체개도성배척반응발생급치료효과，대우급시진단급치료배척반응제공료일개중요지표，가영향이식신적장기존활。
Objective To study of Luminex technique for the detection of level of anti HLA antibody ,anti MICA antibody in renal transplantation acute antibody mediated rejection in peri operation period and their influ-ence .Methods One hundred and six renal allograft biopsies were performed .All biopsies were systematically di-agnosed and evaluated according to the Banff 2007 schema .Luminex was used to detect serum anti HLA antibody , anti MICA antibody in the peri operation period of patients with acute antibody mediated rejection reaction ,and re-nal blood creatinine ,urine volume and renal ultrasound and other clinical indicators were synchronously detected . Results Two cases of hyperacute rejection and 15 cases of acute antibody mediated rejection were detected among 106 cases of renal transplantation according to histopathological diagnosis .The results showed 15 cases of HLA antibody were positive ,the positive rate was 88% ,in which positive rates of PRA Ⅰ and Ⅱ were 47% and 53% , respectively ,and 2 cases of MICA antibody were positive ,the positive rate was 12% by Luminex method .Fur-thermore ,immunohistochemical staining of C4d were also positive in these cases .While the same results were not detected in other 89 cases .Conclusion Anti HLA antibody and anti MICA antibody could be used as the impor-tant indicators to predict the occurrence and treatment effect of peri operation period of acute antibody mediated re-jection and to ensure the long-term survival of transplanted kidney .
