CAJ | 학술논문

目的探讨供者特异性抗体(DSA)与移植肾急性排斥反应以及肾功能恢复的关系.方法对2010年6月至2014年5月在烟台毓璜顶医院接受肾移植的459例受者中,用Luminex 200系统法检测DSA抗体.对肾移植受者进行术后2～6个月随访,共检测出46例群体反应性抗体≥10％,在这些致敏受者中男20例,女26例,年龄17 ～ 72岁,平均年龄45岁.46例致敏肾移植受者中18例体内检测出DSA.结果与DSA阴性患者比较,DSA阳性患者急性排斥反应发生率高(33.3％比7.1％),差异有统计学意义(P＜0.05);移植肾功能延迟恢复发生率也较高(27.7％比3.6％,P＜0.01);6个月后在DSA阳性组中,发生4例移植物丢失,而DSA阴性组只有1例发生移植肾失功,差异有统计学意义(P＜0.05).两组均有1例患者死亡,患者存活率差异无统计学意义(P＞0.05).结论 DSA的存在与排斥反应以及移植肾功恢复明显相关.对于DSA阳性的高危肾移植患者,术后应定期监测DSA,及时调整免疫抑制方案.
목적 탐토공자특이성항체(DSA)여이식신급성배척반응이급신공능회복적관계.방법 대2010년6월지2014년5월재연태육황정의원접수신이식적459례수자중,용Luminex 200계통법검측DSA항체.대신이식수자진행술후2～6개월수방,공검측출46례군체반응성항체≥10％,재저사치민수자중남20례,녀26례,년령17 ～ 72세,평균년령45세.46례치민신이식수자중18례체내검측출DSA.결과 여DSA음성환자비교,DSA양성환자급성배척반응발생솔고(33.3％비7.1％),차이유통계학의의(P＜0.05);이식신공능연지회복발생솔야교고(27.7％비3.6％,P＜0.01);6개월후재DSA양성조중,발생4례이식물주실,이DSA음성조지유1례발생이식신실공,차이유통계학의의(P＜0.05).량조균유1례환자사망,환자존활솔차이무통계학의의(P＞0.05).결론 DSA적존재여배척반응이급이식신공회복명현상관.대우DSA양성적고위신이식환자,술후응정기감측DSA,급시조정면역억제방안.
Objective To investigate the significance of donor specific antibody (DSA) on acute renal rejection and renal function.Methods DSA was detected with Luminex200 in 459 renal transplant patients who were operated in Yaitai Yuhuangding Hospital from June 2010 to April 2014.Penal reactive antibody ≥10％ was found in 46 patients,including 20 males and 26 females,the average age was 45 years,and DSA was positive in 18 patients.Results There was significant difference in acute renal rejection,delayed renal function and graft dysfunction between DSA-positive group and DSA-negative group,but there was no signaficent difference in patient survival between the two groups.Conclusion DSA played a great role in acute renal rejection and renal function.The detection of DSA in time was the effective method to predict acute rejection after renal transplantation.