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目的了解激活型NK细胞受体(S-KIR)基因组合型与肝脏移植后急性排斥反应(AR)发生率的相关性。方法采用PCR-SSP技术对56例接受异体肝脏移植的供受者进行KIR基因分型,采集受者移植前后的临床信息,采用SPSS16.0软件进行统计学分析。结果抑制型KIR(L-KIR,基因型AA)在肝移植患者中占50%(28/56),其表达频率为0.499;激活型KIR(S-KIR,基因型AB/BB)在肝移植患者中占50%(28/56),其表达频率为0.500。56例受者中有16例发生了AR,发生率28.6%,发生时间为术后7~30d,中位时间为术后14d。16例术后发生AR的患者中,受者为L-KIR者的AR发生率为18.8%(3/16),受者为S-KIR者的AR发生率为43.8%(7/16),差异无统计学意义(P>0.05);供者为L-KIR者的AR发生率为25.0%(4/16),供者为S-KIR者的AR发生率为12.5%(2/16),差异亦无统计学意义(P>0.05)。在移植后发生AR的受者中表达1个KIR激活基因(S1)的占16.67%,表达≥2个KIR激活基因(S2)的占83.33%,差异有统计学意义(P<0.05)。结论肝移植受者S-KIR组合型及其数目与术后AR的发生率存在关联。在肝移植受者中进行KIR检测,可为肝移植后小剂量、低浓度、联合抗排斥药物的临床应用提供参考。
Objective To investigate the association of activated K-type cytokine receptor (S-KIR) genotype with the incidence of acute rejection (AR) after liver transplantation. Methods PCR-SSP technique was used to genotype KIR genotypes of 56 recipients who underwent allogeneic liver transplantation. The clinical data of recipients before and after transplantation were collected and analyzed by SPSS16.0 software. Results The inhibitory KIR (L-KIR, genotype AA) accounted for 50% (28/56) of patients with liver transplantation and the frequency of expression was 0.499. The activated KIR (S-KIR, genotype AB / BB) Among the patients, 50% (28/56) were expressed at a frequency of 0.500. AR occurred in 16 of 16 patients (28.6%) and occurred at 7 to 30 days after surgery. The median time was 14 days . Of the 16 patients who developed AR after surgery, the incidence of AR was 18.8% (3/16) in those who received L-KIR, 43.8% (7/16) in those who were S-KIR, (P> 0.05). The incidence of AR was 25.0% (4/16) in donor of L-KIR and 12.5% (2/16) of AR in donor of S-KIR , The difference was not statistically significant (P> 0.05). In the recipients of AR after transplantation, the expression of one KIR activation gene (S1) accounted for 16.67% and the expression of two or more KIR activation genes (S2) accounted for 83.33%, the difference was statistically significant (P <0.05). Conclusions The S-KIR combination and its number in liver transplant recipients are associated with the incidence of postoperative AR. KIR detection in liver transplant recipients may provide a reference for the clinical application of low dose and low concentration combined with anti-rejection drugs after liver transplantation.