PRA在肾移植中的应用

Evaluation of PRA Applicated in Renal Transplation

目的探讨肾移植患者血清中群体反应性抗体(PRA)水平与术后急性排斥反应发生率以及患者1、2年存活率之间的关系。方法采用ELISA方法检测62例肾移植患者血清PRA水平,根据PRA的检测结果将患者分为致敏组和非致敏组,观察两组患者移植手术后发生急性排斥反应的情况,并随访PRA对肾移植患者移植效果的影响。结果致敏组患者急性排斥反应发生率较非致敏组增高,差异有统计学意义;且PRA水平与急性排斥反应发生率成正相关;致敏组患者移植后1、2年移植肾存活率较非致敏组降低,差异有统计学意义(P<0.05)。结论术前检测患者血清PRA,对预测移植风险、供体选择、避免急性排斥反应的发生以及提高移植肾长期存活都具有重要的意义。

Objective To investigate the assosiation between the level of PRA and incidence rate of acute rejection and 1,2 years survival rate of patients after renal transplation.Methods 62 patients after renal transplation were admitted,all their sero PRA were detected by enzyme-linked immunosorbent assay（ELISA）.Then patients were divided into sensitized recipients and non-sensitized recipients based on their PRA level,and their acute rejection rate of post-transplation were observed.These patients were followed for a long time,and their clinical effect of PRA in renal transplation were investigated.Results The acute rejection rate of sensitized recipients were significantly higher than non-sensitized recipients,and the PRA level was a parallel relationship with acute rejection rate.The sensitized recipients 1,2 years survival rate were significantly lower than non-sensitized recipients,the difference between two groups was extremely significant（P〈0.05）.Conclusion PRA was a risk factor in renal transplation,serum PRA measured before renal transplation played an important role in prediction of transplation risk,selection of donators,prevention of acute rejection and long-term survival of patients.