摘要
目的探讨HLA-A/B、DR抗原的基因配型对穿透性角膜移植术后免疫排斥的影响。设计实验研究。研究对象北京同仁医院穿透性角膜移植角膜供受体材料150对。方法回顾角膜供受体的基本信息、免疫排斥反应发生情况、可能引起排斥反应的高危因素。对供体角膜环和受体病变组织采用多聚酶链式反应-序列特异性引物(PCR-SS)法进行HLA-A/B、DR抗原的基因检测及配型。根据供体与受体HLA配型是否一致分为配型符合组及配型不符合组。采用χ^(2)检验对组间排斥反应率进行比较。采用Logistic回归分析基因配型及其他相关危险因素对发生排斥反应的发生风险。主要指标不同HLA抗原基因配型的排斥反应发生率;发生排斥反应的OR值。结果150对角膜组织中HLA-A/B配型符合组64例,3例(4.69%)发生免疫排斥反应;配型不符合组86例中23例(33.72%)发生排斥反应(χ^(2)=18.430,P<0.001)。HLA-DR配型符合组34例,9例(25.71%)发生免疫排斥反应,配型不符合组115例,23例(20%)发生免疫排斥反应(χ^(2)=0.522,P=0.4699)。HLA-A/B和HLA-DR同时匹配者18例中2例(11.11%)发生免疫排斥反应,不同时匹配的132例中30例(22.73%)发生排斥反应(χ^(2)=1.274,P=0.2591)。Logistic回归显示,校正年龄、术前是否存在高危因素后HLA-A/B配型不符合组与配型符合组比,发生术后排斥反应的OR=20.78(95%CI为4.95~87.16)。结论HLA抗原的基因配型对穿透性角膜移植术后免疫排斥反应有重要影响,其中HLA-A/B抗原基因匹配可降低穿透性角膜移植术后免疫排斥反应,HLA-DR抗原基因匹配不能降低术后免疫排斥反应。
Objective To investigate the efts of HLA-NB,HLA-DR llele matching degree on immune rejeeion afer alogene-ie keratoplasty.Design experimental study.Participants 150 pairs of corneal donor recipient materials of penetrating keratoplasty in Beijing Tongren Hospital.Methods The basic information of corneal donor and recipient,immune rejection and related high-risk factors were reviewed.HLA-A/B,DR was detected and matched with polymerase chain reaction-sequence-specifie primers(PCR-SS)method in donor corneal rings and recipient corneal tissues.It is divided into allele matching group and unmatching group.The rejection rate be-tween groups was compared with chi-square test.Logistic regression was used to analyze the effect of genotype factors and other related risk factors on rection.Main Outcome Measures Rejection rate of different HLA antigen genotypes;OR value of rejection.Results Among all 150 pairs of corneal tissues,64 pairs of HLA A/B antigens were well matched,only 3 cases(4.69%)had immune rejection,and 23 cases(33.72%)of 86 cases with unmatched types had rection reaction(χ^(2)=18.430,P<0.001).For HLA DR antigens,rejection occurred in 9 cases(25.71%)of 34 matched cases and 23(20%)of 115 unmatched cases(χ^(2)=0.522,P=0.4699).Among 18 cases matched with HLA-A/B and HLA-DR at the same time,2 cases(11.11%)developed inmune rejection.Among 132 cases with HLA-AVB and HLA-DR unmatching at the same time,30 cases(22.73%)developed rejection(χ^(2)=1.274.P=0.2591).Logistic regression showed that the OR value of postoperative rejection was 20.78(95%CI,4.95-87.16)in the HLA-A,B unmatching group compared with the matching group afer age and preoperative high-risk factors were adjusted.Conclusions The genotype of HLA antigens has an important influence on the immune rejection after penetrating keratoplasty.HLA-A/B antigen gene matching can reduce graft rejection after keratoplasty.HLA-DR antigen gene matehing cannot reduce graft rejection.
作者
骆非
接英
胡健萍
张晓昭
李丽
潘志强
Luo Fei;Jie Ying;Hu Jianping;Zhang Xiaozhao;Li Li;Pan Zhiqiang(Beijing Institute of Ophthalmology,Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University,Beijing Key Laboratory of Ophthalmology and Visual Sciences,Beijing 100730,China)
出处
《眼科》
CAS
2022年第4期297-301,共5页
Ophthalmology in China
关键词
穿透性角膜移植
基因配型
免疫排斥反应
penetrating corneal allograft
allele matching
immune rejection
