血小板输注无效患者血小板抗体检测及配合输注疗效观察  

Platelet antibody detection and investigation of curative effect of patients with platelet transfusion refractoriness

作　　者：滑世轩[1] 万震[1] 孙长义[1] 岑东 

机构地区：[1]河南省人民医院检验科,郑州450003 [2]宁波市鄞州疾病预防控制中心,浙江宁波315040

出　　处：《医药论坛杂志》2014年第8期33-35,共3页Journal of Medical Forum

摘　　要：目的分析临床血小板输注无效的原因及免疫性抗体阳性率,观察血小板配合性输注的疗效。方法应用酶联免疫吸附试验(ELISA)和固相凝集法对临床出现血小板输注无效(PTR)患者进行血小板抗体检测,对48例产生免疫性血小板抗体的患者,通过计算随机输注组和配合性输注组1h和24h后血小板计数增高指数(CCI),观察配合性血小板输注的疗效。结果血小板抗体阳性患者共48例(38.70%),其中人类白细胞抗原(huaman leukocyte antigen,HLA)的I类分子(HLA-I)抗体阳性37例(29.83%);血小板特异性抗原即人类血小板抗原(human platelet antigen,HPA)抗体阳性4例(3.22%);HLA-I和HPA抗体并存7例(5.64%);血小板交叉配合输注组的有效率(91.67%)显著高于随机输注组(4.34%),有显著统计学意义(P<0.05)。结论 HLA抗体是导致PTR的主要免疫因素,HPA导致的PTR作用相对较弱;患者进行血小板配合性输注可显著提高血小板的疗效和安全性。Objective To analyze the reason of Platelet transfusion Refractoriness（PTR） and The positive rates of immunity antibody. To investigate curative effect of platelet compatible transfusion. Methods The platelet antibody were detected by using ELISA and solid- phase coombs test in cases of Platelet Transfusion Refractoriness（ PTR）. TO observe the curative effect of platelet transfusion by calculating random infusion group and cooperate with infusion platelet increased index after 1 h and 24 h（CCI）. Results Totally 48（38. 70%） cases were platelet antibody positive,which the Human Leukocyte Class I molecules（HLA- I） antibody positive 37 cases（29. 83%）; The human platelet antigens antibody positive in 4 cases（3. 22%）; HLA- I and HPA antibodies coexist in 7 cases（5. 64%）; The effective rate in the experimental group was 91. 67%,and the control group was 4. 34%,the differences were statistically significant（P〈 0. 05）. Conclusion HLA- I antibodies are the major immune factors that led to PTR,HPA antibodies are weakly that led to PTR,With the nature of platelet transfusion in patients may help to improve the efficacy and safety.

关 键 词：血小板抗体 血小板输注无效 血小板配合输注 

分 类 号：R457[医药卫生—治疗学]