HPA基因多态性对肝病患者血小板输注疗效的评估价值  

Value of HPA gene polymorphism in evaluating efficacy of platelet transfusion in patients with liver disease

作　　者：晏丽 李萍[1] 谢小双 YAN Li;LI Ping;XIE Xiaoshuang(Department of Blood Transfusion,Neijiang First People's Hospital,Neijiang,641000,China)

机构地区：[1]内江市第一人民医院输血科,四川内江641000

出　　处：《临床血液学杂志》2022年第6期447-450,共4页Journal of Clinical Hematology

摘　　要：目的:探究血小板抗原(HPA)基因多态性对肝病患者血小板输注疗效的评估价值及血小板输注无效(PTR)的影响因素。方法:以2019年1月至2021年7月治疗的98例肝病患者为研究对象,根据PTR发生情况分为PTR组(25例)及对照组(73例),采用问卷调查收集患者年龄、性别、原发疾病、是否合并感染、是否存在发热症状等临床资料。应用德国QIAGEN公司血液DNA提取试剂盒提取总DNA,行HPA基因多态性检测。结果:本研究纳入肝病患者的HPA-2、HPA-3、HPA-15基因多态性均符合Hardy-Weinberg平衡(P>0.05);PTR组HPA-2、HPA-3、HPA-15基因ab、bb型检出率均高于对照组(P<0.05);HPA-2、HPA-3、HPA-15基因多态性联合检测评估肝病患者血小板输注疗效的ROC曲线下面积(AUC)>0.75;PTR组在存在发热症状、合并感染、血小板体外保存时间>3 d、输注次数≥3次、脾脏厚度≥40 mm的人数比例高于对照组(P<0.05),均为影响肝病患者出现PTR的危险因素(P<0.05)。结论:HPA基因多态性对肝病患者血小板输注疗效具有评估价值,且发热、合并感染、血小板体外保存时间>3 d、输注次数≥3次、脾脏厚度≥40 mm是影响肝病患者出现PTR的危险因素。Objective: To explore the evaluation value of polymorphisms of platelet antigen(HPA) gene for platelet transfusion effect and the influencing factors of platelet transfusion refractoriness(PTR) in hepatopathy patients. Methods: A total of 98 patients with liver disease from January 2019 to July 2021 were divided into PTR group(25 cases) and control group(73 cases) according to the occurrence of PTR. The clinical data such as age, gender, primary disease, CO infection and fever symptoms were investigated by questionnaire. The total DNA was extracted with the blood DNA extraction kit of Qiagen company in Germany, and the HPA gene polymorphism was detected. Results: The polymorphisms of HPA-2, HPA-3 and HPA-15 genes were all in accordance with Hardy-Weinberg equilibrium(P>0.05). The detection rates of types ab and bb in HPA-2, HPA-3 and HPA-15 genes in PTR group were higher than those in control group(P<0.05). AUC of HPA-2 combined with HPA-3 and HPA-15 polymorphisms for evaluating platelet transfusion effect was over 0.75. The proportions of cases with fever, infection, platelet in vitro storage time>3 d, transfusion times ≥3 times and spleen thickness ≥40 mm in PTR group were higher than those in control group(P<0.05). The fever, infection, platelet in vitro storage time>3 d, transfusion times ≥3 times and spleen thickness ≥40 mm were risk factors of PTR(P<0.05). Conclusion: There may be evaluation value of HPA gene polymorphisms for platelet transfusion effect in hepatopathy patients. Fever, infection, platelet in vitro storage time>3 d, transfusion times ≥3 times and spleen thickness ≥40 mm might be risk factors of PTR.

关 键 词：肝病 血小板抗原 血小板输注疗效 

分 类 号：R322.4[医药卫生—人体解剖和组织胚胎学] R457.1[医药卫生—基础医学]