葡萄球菌蛋白A吸附治疗对群体反应性抗体水平的影响

孟建中 彭侃夫 李香铁 于 颖 夏列波

中国血液净化 ›› 2004, Vol. 3 ›› Issue (5) : 240-242.

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中国血液净化 ›› 2004, Vol. 3 ›› Issue (5) : 240-242.
论著

葡萄球菌蛋白A吸附治疗对群体反应性抗体水平的影响

  • 孟建中 彭侃夫 李香铁 于 颖 夏列波
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摘要

目的 研究葡萄球菌蛋白A (Staphylococcal Protein A.SPA)吸附治疗对群体反应性抗体(PRA)水 平的影响。方法 采用SPA吸附系统对32例等待肾移植的致敏受者进行体外吸附实验、体内吸附实验和临床移植观察。结果 ①单次SPA吸附治疗可处理循环血浆450~600 ml;其饱和吸附的IgG量为(3.98±0.51)g;实验终点饱和吸附的IgG量(M1)为(19.54±3.13)g/L,吸附后血浆IgG(M2)水平降低51.2%;②本组体内吸附实验前,PRA 为98%~51%者5例,PRA为50%~40%者15例, PRA为39%~25%者12例。每次SPA吸附治疗的循环血浆量为 7 000~9 000ml。 本组经 (6.70±3.11) 次SPA吸附治疗后, 29例 (占 90.62%)PRA降至<12%;③27例(83.37%)顺利地接受肾移植手术。术后未发生超急或急性排斥反应,肾功能均得以恢复。结论 SPA吸附治疗可降低致敏患者体内预存的PRA水平。SPA吸附治疗辅以配型良好的肾脏及新型免疫抑制剂,对预防和减轻肾移植后排斥反应疗效确切。

Abstract

Objective To evaluate the effect of staphylococcal protein A(SPA) adsorption therapy on panel reactive antibody(PRA). Methods The experiment of SPA adsorption-system was carried out in vitro and in vivo for 32 sensitive recipients [Population reactive antibody (PRA)>25%] patients and clinical kidney transplantation of these patients were observed. Results ①About 450~600ml blood plasma was given out in one SPA adsorption treatment. The mean levels of IgG adsorbtion saturated was (3.98 ± 0.51)g/L; at the end of the experiment the mean level was (19.54 ± 3.13)g/L. The levels of plasma IgG after absorption was decreased by 51.2%; ②Before SPA adsorption therapy, the levels of PRA were: 98%~51% for 5cases、50%~40% for 15 cases and 39%~25% for 12 case. After (6.70± 3.11) times SPA adsorption therapy, the PRA levels decreased to lower than 12% in 29 patients(90.62%)and 7 000~9 000ml circulated plasma involved in every SPA adsorption therapy. ③Twenty-seven cases(83.37%)accepted kidney transplantation, no serious rejection occurred and all recovered. Conclusions To sensitive patients, the levels of PRA could be reduced by the SPA adsorption therapy which had a definitely therapeutic effects on the acute rejections following renal transplantation if combined with better HLA matching model of kidney and new type immunosuppressants.

关键词

肾移植 / 群体反应性抗体 / 葡萄球菌蛋白A / 吸附

Key words

Panel reactive antibody / Staphylococcal protein A / Adsorption

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导出引用
孟建中 彭侃夫 李香铁 于 颖 夏列波. 葡萄球菌蛋白A吸附治疗对群体反应性抗体水平的影响[J]. 中国血液净化. 2004, 3(5): 240-242
中图分类号: R446.6   

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