Rh阴性患者输注Rh阳性单采血小板的疗效分析  

Efficacy analysis on Rh-negative patients transfused with Rh-positive apheresis platelet

作　　者：朱雯雯[1] 李莺[1] 宋志群[1] 赵凌[1] 朱永亮[1] 周小玉[1] 

机构地区：[1]南京医科大学第一附属医院输血科,南京210029

出　　处：《临床血液学杂志（输血与检验）》2016年第6期951-953,共3页Journal of Clinical Hematology(Blood Transfusion & Laboratory Medicine)

摘　　要：目的:回顾性分析Rh阴性患者输注ABO同型Rh阳性单采血小板的临床治疗效果。方法:在没有预防性输注Rh免疫球蛋白的情况下,给予33例Rh阴性患者输注Rh阳性血小板,检测输注前后各24h的外周血血小板计数,并计算出血小板增加值,与对照组35例阳性患者输注阳性血小板的效果进行比较,来评估血小板输注的疗效。并在随访中,用间接抗人球蛋白卡法检测患者输注血小板后的抗D抗体水平。结果:Rh阴性患者输注Rh阳性血小板24h后血小板增加值为(12.45±9.96)×109/L,阳性患者输注阳性血小板24h后血小板增加值为(8.12±7.63)×109/L,3组数据差异无统计学意义(P>0.05),即Rh阴性患者输注Rh阳性血小板与RhD同型输注血小板治疗效果差异无统计学意义,患者症状明显改善。20例患者输注血小板(66.2±30.0)d后抗D抗体均为阴性。结论:Rh阴性患者输注Rh阳性单采血小板的疗效显著,RhD抗原引起同种免疫的频率极低,可以给予Rh阴性患者输注Rh阳性单采血小板。Objective：To retrospectively analyze the transfusion efficacy of Rh-negative patients with Rh-posive apheresis platelet.Method：Rh-negative patients received Rh-positive apheresis platelet transfusion without injecting immune globulin.The blood platelet counts of these patients 24 hours before and after the transfusions were measured,and the CCI was calculated.And the CCI of control group was calculated at the same time.The CCI of the two groups was compared to evaluate the curative effect.In the follow-up period anti-D of each case was detected by IAT.Result：The CCIs of RhD negative patients group and control group at 24 hafter transfusion were（12.45±9.96）×10^9/L and（8.12±7.63）×10^9/L,respectively.The difference between the CCI of the two groups was assessed using t tests.The bleeding symptoms of patients were well controlled.Twenty of these cases did not get anti-D during（66.2±30.0）days after platelet transfusion.Conclusion：The efficacy of Rh-negative patients transfused with Rh-positive apheresis platelet was outstanding,and the alloimmunization frequency was very low.It would be suitable to transfuse Rh-positive apheresis platelet to Rh-negative patients.

关 键 词：单采血小板 RHD抗原 

分 类 号：R457.1[医药卫生—治疗学]