摘要
目的了解激活型NK细胞受体(S-KIR)基因组合型与肝脏移植后急性排斥反应(AR)发生率的相关性。方法采用PCR-SSP技术对56例接受异体肝脏移植的供受者进行KIR基因分型,采集受者移植前后的临床信息,采用SPSS16.0软件进行统计学分析。结果抑制型KIR(L-KIR,基因型AA)在肝移植患者中di50%(28/56),其表达频率为0.499;激活型KIR(S-KIR,基因型AB/BB)在肝移植患者中占50%(28/56),其表达频率为0.500。56例受者中有16例发生了AR,发生率28.6%,发生时间为术后7~30d,中位时间为术后14d。16例术后发生AR的患者中,受者为L-KIR者的AR发生率为18.8%(3/16),受者为S.KIR者的AR发生率为43.8%(7/16),差异无统计学意义(P〉0.05);供者为L-KIR者的AR发生率为25.0%(4/16),供者为S.KIR者的AR发生率为12.8%(2/16),差异亦无统计学意义(P〉0.05)。在移植后发生AR的受者中表达1个KIR激活基因(SI)的占16.67%,表达≥2个KIR激活基因(s2)的占83.33%,差异有统计学意义(p〈0.05)。结论肝移植受者S-KIR组合型及其数目与术后AR的发生率存在关联。在肝移植受者中进行KIR检测,可为肝移植后小剂量、低浓度、联合抗排斥药物的临床应用提供参考。
Objective To evaluate the effect of activated killer cell immunoglobulin-like receptor (S-KIR) on acute rejection (AR) after cadaveric liver transplantation. Methods Fifty-six randomized pairs of donors and recipients of liver transplantation were investigated to define their KIR genotype with PCR-SSP method. The perioperative clinical data of recipients were collected and statistically analyzed by SPSS 16.0. Results Inhibitory KIR (L-KIR, genotype AA) accounted for 50% (28/56) in the liver transplantation patients, of whom the expression frequency was 0.499; S-KIR (genotype AB/BB) accounted for 50% (28/56), of whom the expression frequency was 0.500. Out of the 56 pairs, AR occurred in16 recipients with an incidence of 28.6%. AR occurred 7-30 days after operation, and the median time was 14 days. AR occurred in 18.8% (3/16) of the recipients with AA assortment and in 43.8% (7/16) with AB/BB assortment, and there was no significant difference between two groups (P〉0.05). AR occurred in 25.0% (4/16) of the donors with AA assortment and in 12.5% (2/16) with AB/BB assortment, and there was also no significant difference between two groups (P〉0.05). AR occurred in 16.67% of the recipients who expressed one activating KIR gene (S1), and in 83.33% of the recipients who expressed two or more than two activating KIR genes ($2), with significant difference between two groups (P〈0.0S). Conclusions The genotype assortment and number of S-KIR may be related to the AR occurrence after liver transplantation. KIR tests of recipients may have significant clinical value in research of the effect of low-dose, low concentration, and combined therapy with anti-rejection drugs after liver transplantation.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2014年第4期311-314,共4页
Medical Journal of Chinese People's Liberation Army
基金
全军医学科技“十二五”科研基金(CWS11J279)
广东省医学科学技术研究基金(B2011060)~~
关键词
杀伤细胞
天然
肝移植
移植物排斥
killer cells, natural
liver transplantation
graft rejection