流式细胞术-群体反应性抗体的检测在临床器官移植中的应用

Application of FLOW-PRA detection in clinical organ transplantation

目的 比较流式细胞术检测群体反应性抗体（FLOW-PRA）的方法与传统的酶联免疫吸附检测群体反应性抗体（ElISAPRA）的方法在临床器官移植巾应朋的相关性、灵敏性、准确性及实用性。方法采用FLOW-PRA和ELISAPRA两种方法对212份等待肾移植患者的血清进行检测，对两种方法的检出结果进行比较分析。结果FLOW-PRA和ELISAPRA两种方法各耗时1．5h和3h。两种方法所得结果有很好的相关性，PRAⅠ类和PRAⅡ类检测结果的相关系数分别为0．94和0．89。采用FLOWPRA法检出PRAI类和Ⅱ类阳性率分别为24．5％和18．4％，采用ELISA-PRA法检出PRAI类和Ⅱ类的阳性率分别为17．9％和14．6％，FLOW-PRA法的阳性检出率明显高于ELISA—PRA法。FLOW-PRA法能准确检测到低浓度抗体及其抗体特异性。结论与ELISA-PRA法相比，FLOW-PRA法简单快捷，有更高的敏感性和准确性，对低致敏患者有更高的阳性检出率，更适合临床器官移植对PRA的检测。

Objective To apply flow cytometry-panel reactive antibody （FLOW PRA） and compare the application of traditional （enzyme-linked immunosorbent assay） ELISA-PRA in clinical organ transplantation, so as to evaluate the concordance, sensitivity, accuracy and practicability of FLOW-PRA. Methods PRA was detected in 212 serum samples from 185 patients awaiting organ transplantation using FLOW-PRA and EIASA-PRA. Results It took 1.5h and 3 h for FLOW-PRA vs ELISA PRA. Concordance correlation coefficient for the results of the two methods was 94% （class Ⅰ） and 89 % （class Ⅱ）, respectively. Of all sera, 24. 5 % （in comparison to ELISA-PRA, P〈0. 005） were class I positive, 18.4% （P〈0.115） class II positive by flow cytometry, and 17.9 % and 14. 6 % by ELISA, respectively. The positive incidence in Flow group was higher than in ELISA group. Low titer of antibodies was detected positively only by flow cytometry, furthermore, the antigen specificity of PRA could only be discriminated by FLOW-PRA. Conclusion Flow cytometry is more sensitive and more accurate than ELISA in PRA detection. FLOW PRA is easy to operate and time-effective, and suitable for clinical application.