血小板特异性糖蛋白(GPⅡb/Ⅲa)及HLA-Ⅰ类混合抗体引起血小板输注无效的检测  

Detection methods for platelet transfusion refractoriness caused by anti-platelet glycoprotein specific antibodies and anti-HLA

作　　者：陈扬凯[1] 邓晶[1] 徐秀章[1] 夏文杰[1] 叶欣[1] 丁浩强[1] 刘静[1] 曾四海[1] 邵媛[1] 王嘉励[1] 李辉[2] 付涌水[1] 

机构地区：[1]广州血液中心,广东广州510095 [2]广东食品药品职业学院生物技术学院

出　　处：《中国输血杂志》2014年第10期1020-1022,共3页Chinese Journal of Blood Transfusion

基　　金：国家自然科学基金(81102294);广东省医学科研基金(B2013344);广州市医药卫生科技一般项目(2013A011124);广州市医药卫生科技重点项目(20121A021021;20121A021020);广州市科技计划项目(2012Y2-00024)

摘　　要：目的探讨血小板混合抗体引起的血小板输注无效(PTR)的检测方法。方法提取1名骨髓增生异常综合征PTR患者的DNA 200μL,通过PCR-SSP方法做血小板特异性抗原(HPA)和人类白细胞抗原(HLA)基因分型,以ELISA法检测患者血浆中的血小板特异性糖蛋白(GPⅡb/Ⅲa)和HLA抗体,用Luminex试剂盒检测HLA-Ⅰ类抗体特异性,以MAIPA法鉴定HPA抗体特异性。结果患者HPA基因型为1aa、2ab、3bb、4aa、5aa、6aa、9aa和15bb;HLA-Ⅰ类抗原为HLA-A*02、A*33,HLA-B*46、B*58;从患者血浆中检出GPⅡb/Ⅲa及HLA-Ⅰ类抗体。该患者的PTR是由GPⅡb/Ⅲa及HLA-Ⅰ类混合抗体引起。结论对于反复输血的患者,输注ABO、Rh(D)同型、HLA和HPA交叉配型相合的相容性血小板,可有效减少PTR的发生。Objective To investigate detection methods for platelet transfusion refractoriness （PTR） caused by I-LPA and HLA mixed antibodies. Methods DNA was first extracted from patient. A standard PCR-SSP assay was then used to genotype the HLA and HPA antigen systems. Anti-platelet glycoprotein specific antibodies （GPIIb/IIIa） and anti-HLA amibodies were both tested by ELISA. HLA-1 class antibody specificity was identified using Luminex;HPA class antibody/specificity was identi- fied using MAIPA. Resets The genotypes of HPA were laa,2ab,3bb,4aa,5aa,6aa,9aa,and 15bb;the genotypes of HLA-I was A^＊02,33;HLA-B^＊ 46,58. Anti-platelet glycoprotein specific antibodies and anti-HLA antibodies were all expressed in patient＇s serum. The platelet transfusion refractoriness in this patient was caused by anti-platelet glycoprotein specific antibodies and anti-HLA antibodies. Conclusion In patients with repeated transfusions,infusion of ABO,Rh （D） of the same type and compatible HLA and HPA platelets from erossmatching can effectively reduce thepossibility of PTR.

关 键 词：血小板输注无效 HPA 血小板特异性糖蛋白抗体 HLA抗体 反复输血 骨髓增生异常综合征 

分 类 号：R457.11[医药卫生—治疗学] R446.62[医药卫生—临床医学]