襄阳地区血小板输注无效患者抗体检测及分析  

Ineffective platelet transfusion in patients with antibody detection and analysis in Xiangyang

作　　者：叶海辉[1] 胡华琼[2] 钟万芬[1] 皮佑珺[1] 侯治兵 黄洪海 

机构地区：[1]襄阳市中心医院检验科,湖北襄阳441021 [2]襄阳市中心医院公共卫生科,湖北襄阳441021 [3]襄阳市中心血站

出　　处：《中国输血杂志》2015年第8期1011-1013,共3页Chinese Journal of Blood Transfusion

摘　　要：目的探讨襄阳地区血小板输注无效患者血小板抗体阳性率及相关因素,为提高输注疗效提供依据。方法对襄阳地区68例血小板输注无效患者和同期60例健康体检人员进行血小板抗体筛检,并对血小板抗体阳性患者进行血小板抗体鉴定,分析人类白细胞抗原(HLA)、人类血小板抗原(HPA)抗体阳性率。结果研究组PLT抗体阳性率29.4%,弱阳性率8.8%,阴性率61.8%;其中HLA抗体阳性率23.5%,HPA抗体阳性率10.3%,HLA抗体合并HPA抗体阳性率4.4%;女性PLT抗体阳性率(31.6%)高于男性(26.7%),但无显著性差异(P>0.05);随着输血次数增加,PLT抗体阳性率增高(χ2=4.146,P<0.05),当输血次数为4-6次时,增高幅度最大。结论襄阳地区血小板输注无效患者中PLT抗体以HLA抗体为主,其次为HPA抗体。PLT抗体阳性率随输血次数增加而增加,并且与性别无关。Objective To explore the ineffective platelet transfusion in Xiangyang area by analyzing platelet antibody positive rate and related factors of patients, and to provide evidence for improving the impact of transfusion. Methods 68 patients with platelet transfusion refractoriness in Xiangyang and 60 cases of healthy individuals were screened for platelet antibody. Those who were positive in platelet antibody identification would undergo an analysis on human leukocyte antigen （HLA） and human platelet antigen （HPA）. Results The positive rate for PLT antibody in the experimental group was 29. 4%. The weakly positive rate was 8. 8% and the negative rate was 61.8%. Of the positive rates for PLT antibody, the positive rate of HLA antibody was 23. 5%, HPA antibody positive rate was 10. 3%, and the combined positive rates for both HPA antibody and HLA antibody were 4. 4%. In females, PLT antibody （31.6%） was higher than males （26. 7% ）, but exhibited no significant differences （P 〉 0. 05）. With the increase in the number of blood transfusion, the positive rate of PLT antibody increased significantly x^2 = 4. 146, P 〈 0. 05）. When the mhnber of transfusion reached 4 to 6 times, optimal increase would be noted. Conclusion The platelet transfusion refractoriness in Xiangyang are attributed to HLA antibody within PLT antibody, followed by HPA antibody. The positive rate of PLT antibody increased with the increase in number of blood transfusion, and has no correlation with gender.

关 键 词：血小板输注无效 HLA HPA 

分 类 号：R457.1[医药卫生—治疗学] R331.143[医药卫生—临床医学]