中国血液净化

›› 2004, Vol. 3 ›› Issue (5): 240-242.

• 论著 • 上一篇    下一篇

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   

  1. 250031 济南，济南军区总医院血液净化中心(孟建中，彭侃夫，于 颖，夏列波)；泌尿外科(李香铁)
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2004-05-12 发布日期:2004-05-12

  • Received:1900-01-01 Revised:1900-01-01 Online:2004-05-12 Published:2004-05-12

RichHTML

0

PDF

205

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。

关键词: 肾移植, 群体反应性抗体, 葡萄球菌蛋白A, 吸附

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.

Key words: Panel reactive antibody, Staphylococcal protein A, Adsorption

中图分类号: