关键词：白细胞抗原；肾移植；细胞毒性试验；免疫
【摘要】
目的 筛选特异性抗人类白细胞抗原 (HLA)-IgG抗体，以评价肾移植受者的致敏状态。方法 血清样本211份，采用微量酶联免疫法莱姆德抗原板(LAT)、混合抗原板(LATM)和补体依赖细胞毒(CDC)方法，随机双盲检测HLA抗体，比较其特异性与敏感性，分析3组肾移植受者的抗体水平。结果 所有样本的检测均获成功。LATM重复性为100%；LAT特异性与敏感性为97.9%～100%、重复性为100%、变异系数(CV)为0.052～0.089；CDC特异性为88.4%、敏感性89.6%、重复性90%、CV为0.081～0.154。临床应用显示：移植肾功能衰竭组HLA抗体致敏率(88%)显著高于首次尸肾移植的术前水平(20%，P<0.01), 差异有非常显著意义。50例LAT、LATM阴性受者，无一例发生超急性排斥反应。结论 LAT、LATM筛选抗HLA-IgG抗体明显优于CDC方法，适合于临床应用。Specific anti-HLA antibody: detection and application
TAN Jianming, TANG Xiaoda, ZHU Zhongyong.
Renal Transplantation Center, Fuzhou General Hospital of PLA, Fuzhou 350025, China
【Abstract】 Objective To screen the specific anti-HLA-IgG antibodies for evaluating sensitization in renal transplantation. Methods 211 sera were blindly detected using the new micro-ELISA Lambda antigen tray (LAT), Lambda antigen tray mixed (LATM) and complement-dependent cytotoxicity (CDC) techniques to compare their specificity and sensitivity. Sensitization was analyzed in the recipients of the three groups. Results All samples were successfully determined by the new micro-ELISA and CDC assay. The reproducibility was 100% for LATM assay. The specificity and sensitivity were 97.9%～100% for LAT technique, and the reproducibility was 100% with CV from 0.052 to 0.089. The specificity however was 88.4%, and the sensitivity was 89.6%. The reproducibility was 90% with CV from 0.081 to 0.154 for CDC test. Clinical application showed that the sensitization of HLA antibody was higher in retransplants with hemodialysis (88%) than in first pre-Tx recipients (20%) (P<0.01). No hyperacute rejection occurred in 50 recipients with negative-LAT and negative-LATM. Conclusion New micro-ELISA of LAT and LATM screening IgG anti-HLA antibodies is more precise than CDC method in clinical practice.
【Key words】 HLA antigens;Kidney transplantation;cytotoxicity tests, immunologic
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