高、中、低龄肾移植患者术前抗HLA抗体产生的频率比较

Comparison of HLA antibody incidence in old, middle and young age patients

目的探讨不同年龄段移植前肾移植患者抗HLA抗体的频率、抗体类型，以此了解各个年龄段产生抗体的不同点，为临床预测不同年龄段患者肾移植术后发生移植肾排斥提供参考。方法肾移植术前患者血清取自2006年1月至2008年6月，凡是年龄小于等于35岁为低龄组，大于等于36岁小于50岁为中年组、大于等于50岁者为高龄组。群体反应性抗体（PRA）检测采用ELISA筛选HIAⅠ类、Ⅱ类混合抗原板。结果。肾移植术前高、中、低龄组抗HLA抗体产生的频率分别为18．18％、23．00％和6．19％，经χ^2检验3组间差异有统计学意义（P〈0．005）。青年组男性与女性抗HLA抗体产生的频率分别为5．59％和8．51％，差异有统计学意义（P〈0．005）。中年组男性与女性抗HLA抗体产生的频率分别为21．30％和25．38％，差异无统计学意义（P〉0．005）。高龄组男性与女性抗HLA抗体产生的频率分别为11．36％和25．00％，差异有统计学意义（P〈0．005）。肾移植术前患者无论在青年组还是在高、中年龄组，抗HLA抗体主要以抗HLAⅠ类抗体和HLAⅠ＋Ⅱ抗体为主。结论肾移植术前高、中、低龄患者抗HLA抗体产生的频率差异具有统计学意义。肾移植术前患者抗HLA抗体主要以抗HLAⅠ类抗体和HLAⅠ＋Ⅱ抗体为主，有移植史的肾移植患者抗HLA抗体生成的频率高于移植术前曾输血和妊娠的妇女。女性患者抗HLA抗体产生的频率高于男性患者。

Objective To investigate the HLA antibody incidence and type renal recipients with different age, and to study the echaracteristics in different age patients, for clinical reference to forecast renal rejection in different age patients. Methods With serum dated from January 2006 to June 2008, patients were classified into three groups ： young group, with age below 35 years ; middle age group, with age from 36 to 50 years ; and old group, with age above 50 years. Penel reactive antibody （ PRA ） were detected using ELISA. Results Pretransplant HLA antibody incidences in the young, middle age, old group were 18.18% , 23.00% and 6.19% , respectively. In young group, HLA antibody incidences were 5.59% and 8.51% in male and female respectively. In middle age group, they were 21.30% and 25.38% in male and female respectively. In old group, they were 11.36% and 25.00% respectively. HLA Ⅰ and HLA Ⅰ ＋ Ⅱantibodies were mainly found in all the three groups in pretansplant. Conclusion HLA Ⅰ and HLA Ⅰ ＋ Ⅱantibodies were mainly found in pretransplant. Antibody incidence was higher in patients who had more than once renal transplant than that in transfusion and pregnancy female. Antibody incidence is higher in female than that in male.