南宁地区血小板输注无效患者血小板同种抗体检测及特异性分析  

Detection and Analysis of Platelet Alloantibody in PTR Patients in Nanning

作　　者：周燕 李丽兰 钟周琳 刘金莲 申卫东 吴国光 

机构地区：[1]广西南宁中心血站 [2]南宁输血医学研究所,530007

出　　处：《临床输血与检验》2015年第2期103-106,共4页Journal of Clinical Transfusion and Laboratory Medicine

基　　金：广西科学研究与技术开发计划项目(No.主席资金08160-05);广西科学研究与技术开发计划项目(No.桂科攻1355005-2-4)资助南宁市科学研究与技术开发计划项目(No.科技惠民重大科技专项No.20133141);广西自然科学基金项目(No.2012GXNSFBA053127)

摘　　要：目的分析血小板输注无效(PTR)患者血小板同种抗体的特异性,以便更好的为临床服务。方法检测并鉴定72例PTR患者血小板同种抗体的特异性;采用流式细胞术(FCM)对其中4例患者进行血小板、单核细胞膜上的CD36抗原检测;基因测序法对上述4例患者进行CD36抗原缺失分型。结果 72例PTR患者中有22例产生血小板同种抗体,其中18例为抗HLA抗体,3例为抗CD36抗体,1例为抗CD36及抗HLA抗体并存;4例含抗CD36抗体的患者经证实均为Ⅰ型CD36缺失个体,基因检测也证实为CD36基因突变所致的CD36抗原缺失。结论 PTR患者血小板同种抗体以抗HLA多见,其次为抗CD36;应对CD36抗原给予足够重视。Objective The specificity in the patients of platelet alloantibodies in platelet transfusion refractoriness（PTR）was detected and analyzed for its appropriate use in platelet transfusion.Methods Serum samples from 72 patients who were refractory to platelet transfusion were tested by ELISA.CD36 expression on platelets and monocytes were examined by flow cytometry（FCM）.The CD36 mutation of the patients was confirmed by gene sequencing.Results Among 72 patients,22patients presented platelet alloantibody,of which 18 cases showed HLA antibodies,3exhibited CD36 antibodies,and CD36 and HLA antibodies coexisted in one patient.The 4patients were found to be typeⅠCD36deficient,and CD36 mutation was identified by gene sequencing.Conclusions The platelet alloantibodies in PTR patients predominantly belong to HLA antibodies,followed by the antibodies against CD36,which is a crucial antigen in Chinese population.

关 键 词：血小板输注无效 同种抗体 CD36缺失 基因突变 

分 类 号：R331.143[医药卫生—人体生理学] R392.11[医药卫生—基础医学]