无偿献血者与患者血小板抗体检测结果分析  

Analysis of voluntary blood donors and clinical patients platelet antibody test results

作　　者：庞桂芝 张趁利 娄白敏 郭欣 赵凤莲 鲍瑞玲[3] 

机构地区：[1]新乡市中心血站,河南新乡453000 [2]新乡市人民医院输血科 [3]新乡市中心医院输血科

出　　处：《中国输血杂志》2015年第2期191-192,共2页Chinese Journal of Blood Transfusion

基　　金：河南省医学科技攻关计划项目(201204161)

摘　　要：目的探讨固定无偿机采血小板献血者与临床患者血小板抗体阳性比例特点,进一步降低临床输血反应。方法采用固相凝集法分别对600例固定无偿机采血小板捐献者及795例临床患者进行血小板抗体检测。结果男性献血者(390例)血小板抗体均阴性,女性(210例)血小板抗体阳性6例(妊娠史>3次者5例,妊娠史<3次者1例)阳性率为2.9%,P<0.05;临床男性患者(392例)血小板抗体阳性17例(输血史>3次者15例,输血史<3次者2例)阳性率为4.3%,女性(403例)血小板抗体阳性21例(输血史>3次且无妊娠史13例占7.9%,无输血史且妊娠史>3次者8例占3.3%)阳性率为5.2%。结论多次妊娠及反复输血可产生血小板抗体。对献血者进行血小板抗体筛查,可避免抗体阳性血小板进入受者体内,血站应尽量减少采集有妊娠史女性和反复输血者的血液,保证安全有效输血。对患者进行血小板抗体检测,抗体阳性者通过输注基因相合的血小板,可降低免疫性血小板输注无效的发生率,减轻患者的经济负担,避免血液资源的浪费。Objective To explore the characteristics of positive platelet antibodies among fixed and voluntary platelet donors and clinical patients and to further reduce clinical transfusion reactions.Methods The presence of platelet antibodies was tested in 600 voluntary platelet donors and 795 clinical patients,using solid-phase agglutination method.Results All male blood donors（390 cases） were negative for platelet antibodies,while six cases in females（210 cases） were positive for platelet antibodies,among which,5 cases had more than three episodes of pregnancy and 1 case had less than three episodes of pregnancy.The positive rate was 2.9%（P0.05）.Among clinical male patients（392 cases）,17 cases were positive for platelet antibodies,among which,15 cases had transfused more than three times,and 2 cases had transfused less than three times.The positive rate was 4.3%.Among clinical female patients（403 cases） 21 cases were positive for platelet antibodies.13 cases,accounting for 7.9%,had a history of blood transfusion3 times and no history of pregnancy; 8 cases,accounting for 3.3%,had no history of blood transfusion but history of pregnancy3 times.The positive rate was 5.2%.Conclusion Multiple pregnancies and repeated blood transfusions can produce platelet antibodies.Performing platelet antibody screening in blood donors can prevent positive platelet antibodies from entering into the patient.Blood stations should minimize the practice of collecting blood from women with history of pregnancies and those who have received blood transfusion repeatedly,in order to ensure the safety and effectiveness of transfusion.Performing platelet antibody screening in clinical patients,who were positive for platelet antibodies and were infused with genetically matched platelets,can reduce the incidence of invalid platelet transfusion caused by immune factors,reduce the economic burden of patients and avoid wasting of blood resources.

关 键 词：无偿献血者 临床患者 血小板抗体 输血史 妊娠史 

分 类 号：R457.11[医药卫生—治疗学] R331.143[医药卫生—临床医学]