肝移植后胆道铸型综合征病人中HLA抗体检测的临床意义

Clinical significance of HLA antibody detection in patients with biliary cast syndrome after liver transplantation

目的 研究肝移植受者体内的HLA致敏状态与胆道铸型综合征的关系以及HLA抗体在预测免疫因素引起胆道铸型综合征中的作用。方法收集52例肝移植病人术前术后8个时间点系列血清共416份，用ELISA法检测受者血清中HLA抗体，将52例病人分为两组，20例无胆道铸型综合征者为对照组，32例发生胆道铸型综合征者设为实验组，分析两组间HLA抗体水平有无显著性差异，及与主要生化指标变化的关系。结果胆道铸型综合征组术后HLA抗体阳性率显著高于对照组（P〈0．05），胆道铸型综合征临床症状恢复时间与HLA-Ⅱ类抗体的出现时间呈负相关性。结论HLA-Ⅱ类抗体的动态监测可作为胆道铸型综合征发牛的预警信号。

Objective To investigate the association of situation of HLA antibody with biliary cast syndrome（BCS）in patients after liver transplantation and explore the role of HLA antibody in predicting BCS caused by immunization. Methods A total of 416 serum samples were collected at 8 time phases before and after liver transplantation from 52 patients. The 52 patients were divided into the BCS group（n=32）and NBCS group（n=20）. The HLA-Ⅰ and HLA-Ⅱ antibodies in the serum samples were detected with ELISA. Meanwhile, ALT, AST, ALP, GGT, TB and DB were determined. Results The positive rate of HLA was significantly higher in the BCS group than in NBCS group （P〈0.05）. The recovery time of biliary complications were negatively correlated to the appearance time of HLA- Ⅱ antibody. Conclusion HLA-Ⅱ antibody can be dynamically monitored to help predict the biliary complications in liver transplantation recipients.