中文摘要：

目的研究肾移植术后5年内移植肾功能丧失与HLA多态性的相关性。方法以2000年1月至2009年2月间的肾移植受者为对象，其中移植肾功能丧失的受者50例（移植肾功能丧失组），移植肾功能正常的受者701例（对照组）。采用序列特异引物聚合酶链反应（PCR-SSP）技术进行HL艮A、HLA-B、HLA-DRB1基因低到中分辨水平分型，对存在易感基因的样本采用聚合酶链反应-碱基序列分析（PCR-SBT）技术进行HLA高分辨分型。应用SPSS统计软件分析两组间HLA分布的差异。结果移植肾功能丧失组共表达47个HLA基因，HLA-A、HLA-B、HLA-DRB1位点分别表达16、19和12个基因，其中基因表现型频率（PF）≥0．1的HLA基因最多，占总基因数的42．55％（20／47），0．1〉PF≥0．05和PF〈0．05的HLA基因分别占34．04％（16／47）和23．40％（11／47）。移植肾功能丧失组HLA-DRB1＊17（03）的频率显著高于对照组（基因型频率分别为0．213和0．062，Pc=0．000），PCR-SBT检测携带HLA-DRB1＊17（03）的样本，发现移植肾功能丧失组受者该基因的高分辨分型100％（19／19）为DRB1＊03：01，对照组中98．81％（83／84）为DRB1＊03：01，移植肾功能丧失组DRB1＊03：01的频率显著高于对照组[Pc=0．000，比值比=4．564，95％可信区间为（2．466，8．444）]。结论肾移植术后5年内移植肾功能丧失的受者中，HLA-DRB1＊03：01等位基因的频率显著增高，说明HLA-DRB1＊03：01等位基因本身可能就是导致移植肾5年内功能丧失的易感基因。

英文摘要：

Objective To study the association between HLA polymorphism and graft failure after kidney transplantation in 5 years. Method Seven hundreds and fifty-one cases of recipients with a follow-up period 〉5 years from Jan. 2000 to Feb. 2009 after transplantation were collected, including 50 cases of graft failure after kidney transplantation in 5 years as graft failure group and 701 with good function graft as control group. Polymerase chain reaction-sequence specific primers （PCR-SSP） technique was used to analyze HLA-A, B, DRB1 in low- to medium-resolution typing. Polyrnerase chain reaction-sequence based genotyping （PCR-SBT） technique was used to analyze the presence of susceptibility genes for HLA high-resolution typing. SPSS13. 0 statistical software was used to analyze the difference of HLA distribution between two groups. Result Forty-seven HLA genes were expressed in the graft failure recipients, including 16, 19 and 12 genes respectively at HLA-A, B, DRB1 loci. The phenotype frequency （PF） was ≥0. 1 in 42. 55% （20/47）, 0. 1〉PF≥0. 05 in 34. 04% （16/47）, and PF（0. 05 in 23. 40% （11/47） respectively. The frequency of HLA-DRB1 ~ 17 （03） was significantly higher in graft failure group than in control group （0. 213 vs. O. 062, OR = 4. 564, 95% CI （2. 466, 8. 444）, Pc = 0, 000）. SBT sequencing showed the high-solution typing of HLA-DRB1 ＊ 17（03） in graft failure group and control group was 100~//00 and 98. 81% for DRB1 ＊ 03：01, respectively. Conclusion HLA-DRB1 ＊ 03：01 was highly expressed in recipients with graft failure in 5 years following renal transplantation. It hints that HLA-DRB1＊ 03 ： 01 allele itself may be the susceptibility genes that lead to graft failure in 5 years.