等待肾移植患者群体反应性抗体阳性多因素分析及意义

Influence of multiple factors on positive panel reactive antibodies in patients waiting for kidney transplantation

目的研究多种因素对等待肾移植的终末期肾衰患者体内群体反应性抗体阳性的影响及意义。方法运用酶联免疫吸附试验检测广州南方医院等待肾移植患者血清PRA,分析年龄、性别、妊娠史和输血史等因素与PRA结果的关联性,并采用多因素logistic回归进行分析。结果女性PRA阳性风险是男性的5.591倍（OR 95%CI：3.148～9.931）,有输血史者是无输血史者的2.692倍（OR 95%CI：1.543～4.699）,有移植史者是无移植史者的5.059倍（OR 95%CI：2.265～11.299）。年龄及妊娠史与PRA阳性无显著关联（P＞0.05）。结论性别和输血史为PRA阳性的独立影响因素;年龄和妊娠史与PRA阳性无显著关联;移植史对PRA的影响有待进一步的研究。

Objective To explore the influence of multiple factors on positive panel reactive antibodie（ PRA） in patients with ESRD waiting kidney transplantation. Methods ELISA was used to detect the serological PRA in patients waiting for kidney transplantation from Guangzhou Nanfang Hospital. Age,sex,transfusion,transplant and pregnancy were assumed as the potential risks to explore association with positive PRA using logistic regression. Results The risk of females were 5. 591times of males（ OR 95% CI： 3. 148 ～ 9. 931）; that of transfusion recipients were 2. 692 times of non-transfusion recipients（ OR 95% CI：1.543 ~4.699）; the risk of 5.059 was showed in transplanted patients vs. non-transplant ones（ OR 95% CI：2. 265 ～ 11. 299）. There were no significant associations between the positive PRA in both age and pregnancy（ P 〉0. 05）.Conclusion Sex and transfusion were independent influencing factors of sensitization of PRA. There was no statistically significant association between age and pregnancy. The impact of history of transplant on PRA needs to be further studied.