血小板抗体产生的影响因素分析  

Influencing factors of platelet antibody production

作　　者：冯红梅[1] 蔡祥胜 杨兆收 钟惠英 汤颖思 王若帆 林翠琼 郭煜[1] FENG Hongmei;CAI Xiangsheng;YANG Zhaoshou;ZHONG Huiying;TANG Yingsi;WANG Ruofan;LIN Cuiqiong;GUO Yu(Department of Blood Transfusion,First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou 510080,China)

机构地区：[1]广东药科大学附属第一医院输血科

出　　处：《广东药科大学学报》2019年第5期674-678,共5页Journal of Guangdong Pharmaceutical University

摘　　要：目的通过分析患者血小板抗体筛查结果,探讨血小板抗体产生的主要影响因素,为安全输血提供依据。方法选取2018年8月—2019年5月收治的待产孕妇190例和有输血史的患者744例作为研究对象,无妊娠史、无输血史的健康人22例为阴性对照。均采用固相凝集法进行血小板抗体检测,从病型、性别、年龄、输血次数、妊娠史分析影响血小板抗体阳性率的因素。结果934例被检者血小板抗体阳性有141例,阳性率为15.10%(141/934)。孕产妇阳性率19.47%(37/190)。有输血史的744名患者中血液病患者阳性率17.13%(31/181)、肿瘤患者阳性率16.59%(37/223)、肾病5期患者阳性率16.07%(9/56)、急性出血患者阳性率10.81%(8/74)、其他病型阳性率9.05%(19/210)、对照组阳性率4.55%(1/22),不同病型组间比较差异有统计学意义(P<0.05);男性患者阳性率13.49%(53/393)、女性患者阳性率14.53%(51/351);1~20岁患者阳性率14.55%(16/110)、21~50岁患者阳性率18.02%(38/211)、51~80岁患者阳性率12.22%(38/311)、81~100岁患者阳性率10.71%(12/112),不同性别、不同年龄组间比较差异无统计学意义(P>0.05);输血≥5次的患者阳性率20.97%(56/267)、2≤输血≤4次的患者阳性率13.29%(23/173);输血1次患者阳性率8.22%(25/304);输血次数越多,抗体阳性率越高,组间比较差异有统计学意义(P<0.05)。结论反复输血和妊娠可能是影响血小板抗体产生的主要因素。Objective To analyze the results of platelet antibody screening in patients,and explore the main influencing factors of platelet antibody production,so as to provide basis for safe blood transfusion.Methods 190 pregnant women and 744 patients with blood transfusion history who were admitted from August 2018 to May 2019 were selected as the study subjects.22 healthy people without history of pregnancy and blood transfusion were selected as negative control.The platelet antibody was detected by solid-phase agglutination method.The factors affecting the positive rate of platelet antibody were analyzed from disease type,sex,age,number of blood transfusion and pregnancy history.Results 141 of 934 patients were platelet antibody positive,and the positive rate was 15.10%(141/934).The positive rate of platelet antibody in pregnant women was 19.47%(37/190).Among 744 patients with history of blood transfusion,the positive rate in patients with hematological diseases was 17.13%(31/181),cancer patients was 16.59%(37/223),nephropathy stage 5 patients was 16.07%(9/56),acute hemorrhage was10.81%(8/74),and other diseases was 9.05%(19/210).The positive rate in control group was 4.55%(1/22).There was a significant difference between different disease groups(P<0.05).The positive rate in male patients was 13.49%(53/393),and in female patients was 14.53%(51/351).The positive rate in patients with different ages was 14.55%(16/110;ages 1-20),18.02%(38/211;ages 21-50),12.22%(38/311;ages 51-80),and 10.71%(12/112;ages 81-100),respectively.By gender and age,there was no significant difference in the positive rate of platelet antibody test in groups(P>0.05).The positive rate in patients with blood transfusion(>5 times)was 20.97%(56/267),the positive rate in patients with blood transfusion(2≤blood transfusion≤4 times)was 13.29%(23/173),and the positive rate in patients with blood transfusion(one time)was 8.22%(25/304).The more times of blood transfusion,the higher the positive rate of antibodies was produced(P<0.05).Conclusion Repeated b

关 键 词：血小板抗体筛查 反复输血 妊娠 血小板输注无效 

分 类 号：R446.11[医药卫生—诊断学]