关键词：移植免疫学；抗体
【摘要】 目的 评价酶联免疫法和细胞毒法在器官移植方面 的应用价值。 方法 采用酶联免疫法(LATM、LAT、STAT)和细胞毒法( LCT)检测211份血清样本HLA抗体，比较其特异性与敏感性，分析三组肾移植受者的致敏状态 。 结果 除2份STAT测定无结果外，其他样本均获有效结果。与LATM 比较，LAT特异性97.9%、敏感性100.0%、重复性100.0%、变异系数(CV)=5.2%～8.9%；ST AT特异性92.6%、敏感性90.6%、重复性94.0%、CV=7.3%～12.6%；LCT特异性88.4%、敏 感性89.6%、重复性90%、CV=8.1%～15.4%。移植肾失功者HLA抗体致敏率超过80.0% ，首 次尸肾移植术前致敏率20.0%、术后略有升高(27.0%～31.7%)。 结论 酶联免疫法测定HLA-IgG抗体，特异性与敏感性高、重复性好，适合于国内器官移植临床 应用。推荐采用LATM定性筛选、LAT定量分析
A comparative study of different methods for the detection of a nti-HLA-IgG antibodies in organ transplantation
TAN Jianming,TANG Xi aoda,ZHOU Yongchang.
(Renal Transplantation Center,Fuzhou General Hospital of PLA, Fuzhou 350025,China)
【Abstract】 Objective To evaluate some methods in the d etection of HLA-IgG antibodies in organ transplantation. Methods HLA-IgG antibodies in 211 sample s of serum were detected by means of ELISA including LATM,LAT and PRA-STAT or b y microlymphocytotoxicity(CDC)with LCT.Specificity and sensitivity of the 4 meth ods were compared. Results The assay has been successful either by ELISA or CDC except in 2 samples by STAT.The specificity and sensitiv ity of LAT assay as compared with LATM was 97.9%～100% and the reproducibility 1 00% with CV=5.2%～8.9%.For STAT assay,the specificity was 92.6% and sensitivity 90.6% with a reproducibility of 94.0% and CV=7.3%～12.6%.The specificity of LCT assay was 88.4%,the sensitivity 89.6% and the reproducibility 90.0% with CV=8.1% ～15.4%.Sensitization was over 80.0% in retransplants with hemodialysis and 20.0 % in patients before transplantation for the first time.Sensitization slightly e levated(27.0%～31.7%) in po st-transplants. Conclusions ELISA has been more specifi c and sensitive in detecting IgG anti-HLA antibodies with well reproducibility and is recommended for clinical application in organ transplantation.Qualitative screening by LATM and quantitative analysis by LAT were recommended.
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