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目的研究肾移植供受者的细胞因子和细胞因子受体单核苷酸多态性对术后早期移植物急性排斥反应的影响。方法(1)根据有无急性排斥发生,129例肾移植受者分成急性排斥组和无排斥组(6个月内),根据HLA-A-B-DR错配、神经钙蛋白抑制剂、肾功能延迟恢复、ATG或MAb诱导治疗、冷缺血时间等情况,对两组患者进行比较,并比较两组5种细胞因子及5种受体的21个位点的基因型分布情况。(2)根据HLA-DR配型情况分成0~1个HLA DR位点错配组(0~1MM)、HLA-DR完全错配组(2MM),比较两组基因多态性的分布情况。结果(1)129例肾移植受者中,39例(30.2%)发生急性排斥反应。(2)急性排斥组HLA-DR错配数和无排斥组中差异有统计学意义(P<0.05)。(3)细胞因子和细胞因子受体位点的多态性在急性排斥组和无排斥组中的分布有明显不同,差异有统计学意义。(4)HLA-DR完全错配组(2MM组)和0~1个位点错配组(0~1MM组)进行比较,两者多态性分布亦有不同。结论肾移植供受者不同基因多态性对预测排斥的发生有指导意义。
Objective To investigate the effects of single nucleotide polymorphisms of cytokines and cytokine receptors on acute rejection of early postoperative graft in renal transplant recipients. Methods (1) According to the presence or absence of acute rejection, 129 renal transplant recipients were divided into acute rejection group and non-rejection group (within 6 months). According to HLA-AB-DR mismatch, calcineurin inhibitor, Recovery, ATG or MAb induction therapy, cold ischemia time and so on, compared the two groups of patients and compared the genotypes of 21 loci of 5 cytokines and 5 receptors in two groups. (2) According to the distribution pattern of HLA-DR, there were 0 ~ 1 HLA DR loci mismatch (0 ~ 1MM) and HLA-DR complete mismatch (2MM), and the distribution of polymorphism was compared. Results (1) Among 129 renal transplant recipients, 39 (30.2%) patients developed acute rejection. (2) The HLA-DR mismatch number and no rejection group in acute rejection group had significant difference (P <0.05). (3) The distribution of cytokines and cytokine receptor sites in acute rejection group and non-rejection group were significantly different, the difference was statistically significant. (4) HLA-DR complete mismatch group (2MM group) and 0 ~ 1 loci mismatch group (0 ~ 1MM group) were compared, the distribution of the two polymorphisms were also different. Conclusion The different genetic polymorphisms of donor and recipient in renal transplantation have guiding significance in predicting the occurrence of rejection.