HLA-DRB1基因配型与高危角膜移植排斥关系的回顾性研究

摘要

目的 评价HLA基因配型在减少高危角膜移植免疫排斥反应中的作用。方法 对91例高危穿透性角膜移植病例，术后双盲法进行供受体HLA-DRB1基因分型和临床观察，随访12～26mo，对其基因配型情况和术后排斥反应的关系进行回顾性分析。结果 91例患者中61例随访资料完整。其中16例供受体有1个基因位点相符，在这些配型良好的病例中，5例(31.24%)发生免疫排斥反应，但随访期间无植片混浊；45例配型不好的患者中，术后23例(51.11%)发生免疫排斥反应，其中5例发生了植片混浊。结论 HLA-DRB1基因配型未能显著减少角膜移植术后的免疫排斥反应。%Objective To evaluate the efficacy of the use of HLA-DRB1 genetictyping in high risk corneal transplantation.Methods Total of 91 high risk penetrating keratoplasty(PKP) patients were enrolled in this double masked study. HLA-DRB1 genetic typing was performed for both donors and recipients immediately after PKP, and were followed up for 12 to 26 months using a double masked design. The correlation between the graft rejection and HLA-DRB1 matching was analysed retrospectively.Results Sixty-one of 91 cases had complete follow-up data. Only 5 of 16 (31.24%)well-matched patients (1 gene loci matched)had graft rejection during the study period with no grafts failure. In 45 poor matched patients, 23 of 45 (51.11%)had more than one episode of rejection with 5 grafts failure.Conclusion Good HLA-DRB1 matching did not result in the reduction of the corneal graft rejection.