中文摘要：

目的探讨等候肾移植者群体反应性抗体（PRA）阳性率的变化及HLA致敏途径对其的影响。方法对1991年1月至2010年12月间来自51个。肾移植中心的8926例等候肾移植者10555例次血液样本PRA检测的结果进行分析。1991～1998年组采用补体依赖的细胞毒性试验技术检测PRA；1999-2010年组采用酶联免疫吸附试验技术检测PRA。搜集患者的临床资料，分析输血、妊娠和移植对PRA阳性率的影响。结果8926例中PRA阳性者为1324例（14．83％），其中1991-1998年的PRA平均阳性率为18．17％（513／2823），1999-2010年的结果为13．29％（811／6103），差异有统计学意义（P〈0．01）。1324例PRA阳性者中，PRA为1％～30％者占71．83％；PRA〉~30％者占28．17％。既往有血液成分输血史者的PRA阳性率为31．77％，无输血史者的PRA阳性率为1．21％，差异有统计学意义（P〈0．01）。女性患者中，有妊娠史者的PRA阳性率为24．64％；无妊娠史者的PRA阳性率为7．19％，差异有统计学意义（P〈0．01）。初次移植者的PRA阳性率为13．35％，既往有肾移植经历的受者的PRA阳性率为40．62％，差异有统计学意义（Pd0．01）。结论近20年大多数PRA阳性者其PRA〈30％。输血和肾移植史是导致PRA阳性的重要影响因素；妊娠史是PRA阳性的关联因素。

英文摘要：

Objective To investigate the changes of panel reaction antibody （PRA） and the effects of HLA sensitized paths in patients waiting for renal transplantation. Methods PRA of 10 555 samples from 8926 renal transplant recipients in 51 transplant centers was analyzed. In 1991-1998 group, PRA was by using NIH-CDC technique, and in 1999-2010 group, PRA was detected by using ELISA. The effects of blood transfusion, pregnancy and transplantation on the PRA positive rate were analyzed. Results There were 1324 recipients positive for PRA in 8926 （14. 83 %）. The average PRA positive rate in 1991-1998 group and 1999-2010 group was 18. 17% （513/2823） and 13. 29% （811/6103） repectively （P〈0. 01）. Among 1324 PRA positive recipients, the number of recipients with PRA of 1%-30% and PRA of ≥30% respectively accounted for 71. 83% and 28. 17%. There were statistically significant differences in the PRA positive rate between the recipients receiving blood transfusion and those without blood transfusion （31.77% vs 1.21%, P 〈 0. 01 ）, between the recipients having pregnancy history and those without pregnancy history （24. 64% vs 7. 19%, P〈0. 01）, and between primary transplant and re-transplant recipients （13.35 % vs 40. 62%, P〈0. 01）. Conclusion In last 20 years, PRA in majority of PRA positive recipients was 〈30% （low sensitized）. Renal transplantation and blood transfusion were the important influencing factors that led to positive PRA, and pregnancy history was a related factor.