反复输血后血小板输注无效患者抗体阳性率、特异性及影响因素分析  

Analysis of positive rate,specificity and influencing factors of PLT antibody detection in patients with ineffective platelet transfusion after repeated transfusion

作　　者：张桂芬[1] 闫萌[2] ZHANG Guifen;YAN Meng(Department of Transfusion,Baoding First Central Hospital,Baoding,071000,China;Departmentof General Surgery,Baoding First Central Hospital)

机构地区：[1]保定市第一中心医院输血科,河北保定071000 [2]保定市第一中心医院普外科

出　　处：《临床血液学杂志（输血与检验）》2020年第3期391-393,共3页Journal of Clinical Hematology(Blood Transfusion & Laboratory Medicine)

摘　　要：目的:分析反复输血后血小板(PLT)输注无效患者PLT抗体检测阳性率、特异性及其影响因素。方法:随机选取2015-11—2017-11反复输血后PLT输注无效住院患者的血清标本80例,通过固相凝聚法检测PLT抗体,并统计人类白细胞抗原(HLA)、人类PLT抗原(HPA)及PLT同种抗体的特异性及阳性率,同时分析其与性别、年龄、输血成分、输血次数等因素的关系。结果:PLT输注无效患者的PLT同种抗体检出率为64.00%(52/80),其中同种HLA、HPA抗体阳性率分别为43.75%(35/80)、21.25%(17/80),且58.82%(10/17)HPA抗体阳性患者同时被检出HLA阳性;PLT自身抗体阳性检出率是12.50%(10/80)。男性患者的PLT抗体阳性检出率低于女性患者,但差异无统计学意义(P>0.05);不同类型输血成分中,悬浮红细胞70.00%(14/20)高于少白细胞悬浮红细胞25.00%(5/20),浓缩PLT 95.00%(19/20)高于单采PLT 70.00%(14/20)(P<0.05);PLT抗体的数量与输血次数呈正相关(P<0.01)。结论:反复输血后PLT输注无效患者以同种HLA、HPA抗体最为常见,且PLT抗体的数量与输血次数呈正相关,不同的输血成分与产生的PLT抗体有着密不可分的联系。Objective:To analyze the positive rate,specificity and influencing factors of PLT antibody detection in patients with ineffective platelet transfusion after repeated transfusion. Method:The serum samples of 80 inpatients who were ineffective after repeated blood transfusion were selected from November 2015 to November 2017 in our hospital.The platelet antibodies were detected by solid phase coagulation,and the specificity and positive rate of HLA,HPA and platelet alloantibodies were measured,and the relationship between these and sex,age,blood transfusion composition and transfusion times were analyzed. Result:The detection rate of platelet alloantibody was 64.00%(52/80)in patients with ineffective platelet transfusion,in which the positive rates of homologous HLA and HPA antibodies were 43.75%(35/80)and 21.25%(17/80)respectively,and 58.82%(10/17)HPA antibody positive patients were detected at the same time,and the positive rate of platelet autoantibody was 12.50%(10/80).The positive rate of platelet antibody in male patients was lower than that of female patients,but the difference was not significant(P>0.05).Among the different types of blood transfusion,suspended red cell 70.00%(14/20)was higher than that of little white blood red blood cells 25.00%(5/20),and 95.00%(19/20)of concentrated platelets was higher than that of single extracted platelets 70.00%(14/20)(P<0.05).There was a positive correlation between the number of platelet antibodies and of transfusion times(P<0.01).Conclusion:The homologous HLA and HPA antibodie are most common in patients with ineffective platelet transfusion after repeated blood transfusion,and the number of platelet antibodies is positively correlated with blood transfusion times,and there is an inseparable relationship between different components of blood transfusion and produced platelet antibody.

关 键 词：血小板 自身抗体 PLT抗原 同种抗原 

分 类 号：R555[医药卫生—血液循环系统疾病]