【摘要】 目的分析基于酶联免疫吸附试验(enzyme-linked immune absorbentassay,ELISA)的莱姆德抗原板(LAT1240)与单一抗原检测板(LAT1HD)在肾移植受者抗HLAⅠ类抗体检测中的异同和应用价值。方法采用基于ELISA的用LAT1240与LAT1HD分别检测73例已经莱姆德酶标混合抗原板(LATM)确定抗HLAⅠ类抗体阳性的等待肾移植的患者血清样本。比较两种抗原板的平均阳性反应强度、阳性率、抗体特异性分析等方面的异同。结果两种抗原板的平均阳性反应强度差异无统计学意义(P>0.05)。LAT1HD所测出的抗HLA抗体阳性率较LAT1240低,差异有统计学意义(P<0.05)。两种抗原板分辨出的抗HLA抗体特异性完全相同18例(25%),1例完全不同,其余54例结果存在部分差异。5例样本用LAT1240分辨出包含抗Cw抗原的抗体,而用LAT1HD分辨出用LAT1240未能检出的抗HLA-A或B抗体。用LAT1240检测为高度致敏(群体反应性抗体>60%)的样本中,有9例经群体反应性抗体分析软件不能分析出抗HLA抗体的特异性,但可以由LAT1HD分辨出来。共有21例致敏患者接受了肾移植手术,随访1年以上,人/肾存活率达100%。其中6例发生急性排斥反应,使用抗胸腺细胞球蛋白或甲泼尼龙冲击治疗,5例受者逆转,1例效果不佳。结论与使用LAT1240检测的结果比较,用LAT1HD检测出的特异性抗体更为准确,更适用于临床。更多还原

【Abstract】 Objective To evaluate the sensitivity and specificity of using tray LAT1240 and LAT1HD based on enzyme-linked immune absorbent assay(ELISA) in detecting anti-human leukocyte antigen (HLA) Ⅰantibodies in renal transplant recipient.Methods Anti-HLA antibodies detection by tray LAT1240 and LAT1HD were performed on serum samples from 73 patients awaiting renal transplantation,which had already been confirmed positive by lambda antigen tray mixed(LATM).The average strengh and rate of positive detection,specificity of antibodies of these two kits were compared.Results No significant difference was observed in the average strengh of positive detection between the two ELISA kits (P﹥0.05).The positive rate of LAT1HD was significantly lower than that of LAT1240(P﹤0.05).The detection specificity of anti-HLA antibodies was same in 18 samples(25%),totally different in 1 sample and partially different in another 54 samples by the two assays.Anti-HLA Cw antibodies were detected in 5 samples by LAT1240,while anti-HLA A or anti-HLA B antibodies could be detected by LAT1HD and it couldn’t be detected by LAT1240.In the samples with positive rate of panel reactive antibody(PRA) over than 60% detected by LAT1240,the specificity of anti-HLA antibodies detection could not be analyzed by PRA software in 9 samples but could be detected by LAT1HD.A total of 21 sensitized patients underwent renal transplantation.They were followed-up over 1 year,and the patient/graft survival rates were 100%.Among them,6 patients developed acute rejection,5 of which could be reversed after antithmocyte globulin administration or methylprednisolone pulse therapy and one patient showed no response to treatment.Conclusion The detection of specific antibodies by LAT1HD is more accurate compared with LAT1240 and it is more useful for clinical application.更多还原