血小板型去白细胞滤器的临床应用  

Clinical application of leukocyte reduction filter for platelet

作　　者：许珣[1] 管政[1] 汤博悦 

机构地区：[1]安徽省蚌埠医学院第一附属医院输血科,233004

出　　处：《中华全科医学》2015年第10期1684-1686,共3页Chinese Journal of General Practice

摘　　要：目的血小板抗体是引起血小板输注无效的免疫因素,本研究是通过探讨国产血小板型去白细胞滤器能否降低患者产生血小板抗体的概率和能否推迟患者产生血小板抗体的时间,来评价国产血小板型去白细胞滤器的临床应用价值。方法选取40例近期只输注了3次以上未使用血小板型去白细胞滤器的机采血小板的血液病患者作为非去白细胞组,另选40例近期只输注了3次以上使用血小板型去白细胞滤器的机采血小板的血液病患者作为去白细胞组;2组患者又按血小板不同输注次数均分为a、b、c、d、e 5个组。所有患者均无既往输血史。用固相凝集法分别对每位患者进行血小板抗体筛检。分别计算出非去白细胞组与去白细胞组及其各小组的血小板抗体阳性率。其中,非去白细胞组与去白细胞组的阳性率比较采用χ2检验。结果非去白细胞组有18例患者血小板抗体筛检阳性,阳性率为45.0%(18/40),去白细胞组有5例患者血小板抗体筛检阳性,阳性率为12.5%(5/40);去白细胞组血小板抗体阳性率(12.5%)显著低于非去白细胞组的阳性率(45.0%,χ2=10.31,P<0.05);2组患者血小板抗体阳性率均随着机采血小板输注次数的增加而增加。结论使用国产血小板型去白细胞滤器过滤的机采血小板,能够大大降低患者产生血小板抗体的概率,推迟患者产生血小板抗体的时间,血小板型去白细胞滤器值得临床推广应用。Objective The platelet antibody is the immune factor causing platelet transfusion refractoriness （PTR）. This study is designed to evaluate the clinical value of domestic leukocyte reduction filter for platelet by means of investigating whether these filters could reduce the probability of platelet antibodies in patients or delay the time of generating platelet antibodies. Methods Forty patients with hematological diseases were selected as non leukoreduced group, each of them recently received apheresis platelet transfusion more than 3 times, and these apheresis platelets were all not filtered with leukocyte reduction filter for platelet. Another 40 patients with hematological diseases were selected as leukoreduced group, each of them recently received apheresis platelet transfusion more than 3 times, and these apheresis platelets were all filtered with leukocyte filter for platelet. According to times of apheresis platelet transfusion, each group was divided in- to 5 subgroups named a, b, c, d and e. All the selected patients did not have previous history of blood transfusion. The platelet antibody screening for each patient was respectively done with solid agglutination method. The positive rates of platelet antibody of non leukoreduced group and leukoreduced group and each subgroup were respectively calculated, and the differences of positive rates between non leukoreduced group and leukoreduced group were compared by using Xz test. Results Eighteen cases of positive platelet antibody were screened out in non leukoreduced group with a positive rate of 45 % （18/40） ;5 cases of positive platelet antibody were screened out in leukoreduced group with a positive rate of 12.5 % （5/40）, the differences of positive rates between non leukoreduced group and leukoreduced group was significant （X2 = 10.31, P 〈 0.05 ）. The positive rates of platelet antibody in both groups were increased with numbers of apheresis platelets transfusion times. Conclusion Apheresis platelets filtered with domestic leukocyte r

关 键 词：血小板型去白细胞滤器 血小板抗体 血小板输注无效 机采血小板 血小板抗体筛检 固相凝集法 

分 类 号：R457.1[医药卫生—治疗学] R446.62[医药卫生—临床医学]