血小板抗体检测在成分血输注中的临床意义  

Clinical significance of platelet antibodies detection in blood component transfusion

作　　者：侯春梅[1] 田建波[1] 王鑫鑫[1] 

机构地区：[1]河南省三门峡市中心医院(河南科技大学附属三门峡市中心医院)输血科,河南三门峡472000

出　　处：《中国现代医学杂志》2014年第4期80-83,共4页China Journal of Modern Medicine

摘　　要：目的观察血小板抗体检测阴性和阳性患者血小板输注的临床治疗效果,探讨其相关的临床意义。方法收集2013年1~6月该院血小板抗体检测的病例60例。血小板抗体检测使用固相凝集法。结果 60例血小板输注患者共检测到血小板抗体26例,阳性率为43.3%,其中白血病阳性率为44.4%,再生障碍性贫血阳性率为41.6%,骨髓增生异常综合征阳性率为37.5%,恶性肿瘤阳性率为45.5%,各类疾病之间差异无显著性（P〉0.05）。血小板输注次数〈3次、3~8次和〉8次的患者血小板抗体的阳性率分别为23.8%、46.7%和77.8%,各组之间差异具有显著性（P〈0.05）。血小板抗体阴性和阳性患者血小板输注无效率分别为20.6%和69.2%,抗体阴性组显著低于阳性组（P〈0.01）。血小板抗体阴性患者血小板输注后1 h和24 h CCI值分别为（8.12±1.24）×109/L和（5.03±0.74）×109/L,均显著高于阳性组的（6.77±0.81）×109/L和（3.93±0.61）×109/L（P〉0.05）。结论血小板抗体阳性的患者具有较高的血小板无效输注发生率,相容性血小板配型试验是预防免疫性血小板无效输注的有效方法。【Objective】To detect platelet antibodies in blood component transfusion and explore its clinical significance.【Methods】60 cases of patients received platelet transfusion were enrolled in this study. Platelet antibodies weredetermined by solid-phase agglutination.【Results】26 cases platelet antibodies were detected in 60 cases of patients with platelet transfusion with a positive rate of 43.3%. The positive rate was 44.4%, 41.6%, 37.5%, 45.5% in leukemia, aplastic anemia, myelodysplastic syndrome, and malignant tumor. There was no significant difference among various diseases（P 0.05）. The positive rates of platelet antibody were 23.8%, 46.7% and 77.8% in platelet transfusions 3 times, 3-8 times, and 8 times group, respectively. There was no significant difference among various group（P 0.05）. The rate of platelet transfusion refractoriness was 20.6% and 69.2% in antibody negative and positive group. Antibody-negative group was significantly lower than the positive group（P 0.01）. The CCI values in platelet antibody-negative patients after 1h and 24 h CCI values were（8.12±1.24）×109/L and（5.03±0.74）×109/L, which were significantly higher than that of（6.77±0.81）×109/L and（3.93±0.61）×109/L in platelet antibody-positive group（P 0.05）.【Conclusion】Platelet antibody-positive patients had a higher incidence of platelet transfusion refractoriness, platelet compatibility test was an effective way to prevent platelet transfusion refractoriness.

关 键 词：血小板抗体 血小板无效输注 

分 类 号：R55[医药卫生—血液循环系统疾病]