陕西地区血小板HLA/HPA基因供者库的建库评估及应用策略  

The capacity evaluation and utilization strategy of the platelet donor database with known HLA/HPA genotype in Shaanxi

作　　者：齐珺[1] 李昱辉 王天菊[1] 李凤琴[1] 武君华[1] 尚利侠 陈乐 王满妮[1] 房婕[1] 徐华[1] QI Jun;LI Yuhui;WANG Tianju;LI Fengqin;WU Junhua;SHANG Lixia;CHEN Le;WANG Manni;FANG Jie;XU Hua(Blood Center of Shaanxi Province,Institute of Xi'an Blood Bank,Xi’an 710061,China)

机构地区：[1]陕西省血液中心西安市中心血站,陕西西安710061

出　　处：《中国输血杂志》2022年第8期799-804,共6页Chinese Journal of Blood Transfusion

基　　金：陕西省重点研发计划一般项目(2022SF-098);西安市科技计划项目(20YXYJ0009-5)。

摘　　要：目的探讨陕西地区血小板HLA/HPA基因供者库合适的库容水平及匹配概率,为本地区血小板供者库的建设、维护及应用提供数据支持。方法以11755名中华骨髓库陕西分库造血干细胞志愿捐献者、401名和249名陕西地区无血缘关系多次单采血小板捐献者为对象,分别进行HLA基因多态性分析、HPA基因分型和CD36抗原检测,应用Arlequin 3.5.2.2软件计算HLA、HPA基因频率及单体型频率,并根据表型频率计算找到HLA、HPA全匹配供者概率,评估库容水平。结果获得了陕西地区HLA-A、-B及HPA1-6、10、15、21表型群体多态性资料,在249例健康捐献者中检测到CD36抗原Ⅰ型和Ⅱ型缺失频率均为0.40%(1/249);计算推导得到当血小板供者库库容为194人时,患者有95%的把握能在该库中找到至少1名HPA1-6、10、15、21全匹配供者;1个1500人的血小板供者库有95%的概率可以找到1名HLA-A-B表型频率>0.002或单体型频率>0.001的相同供者,而找到任何1个交叉反应组(CREG)匹配的供者概率应在44.95%~97.57%之间;当供者数为8856、15033时,患者找到1名HLA表型相同的供者的概率可提高至80%和90%。结论在可靠的群体性多态性资料的支撑下,不同地区人群HLA/HPA的分布差异使得各地血小板供者库的建库模式和最适库容不尽相同,有必要应用多种血小板配合型输注策略扩大供者选择范围,从而有效降低建库成本和资源需求。Objective To evaluate the appropriate optimal capacity and matching probability of the platelet donor database with known HLA/HPA genotype in Shaanxi aera, and provide data support for subsequent construction, maintenance and application of the local platelet donor database. Methods A total of 11 755 individuals from the Shaanxi Branch of China Marrow Donor Program, 401 and 249 unrelated random platelet donors in Shaanxi aera were enrolled to the population study of HLA-A,-B polymorphisms, HPA genotyping and CD36 antigen expression, respectively. The frequencies of HLA-A,-B alleles, HPA alleles and haplotypes were calculated with Arlequin 3. 5. 2. 2 software;matching probability and capacity evaluation of platelet donor database was conducted according to the phenotypic frequencies. Results The population genetic and phenotypic polymorphisms data of HLA-A,-B and HPA1-6,10,15,21 in Shaanxi aera were obtained. The frequency of CD36 type Ⅰ or Ⅱ deficiency was 0.40%(1/249). According to the subsequent calculating and deriving, with a database size of 194 donors, the patient having approximate 95% probability could achieve matching of HPA1-6,10,15,21 genotype. With a database size of 1500 donors, there is a 95% probability of matching at least one donor with HLA-A-B phenotype frequency >0.002 or haplotype frequency >0.001;meanwhile, the probability of matching a cross-reactive group donor should be 44.95%-97.57%. Based on database size of 8 856 and 15 033, the probabilities of matching HLA-A,-B phenotype were about 80% and 90%, respectively. Conclusion The differences in the distribution of HLA/HPA polymorphism in different regions make the establishment mode and optimal capacity of platelet donor database different. It is necessary to apply a variety of platelet matching transfusion strategies to expand the range of donor selection, thereby effectively reducing the database construction cost and resource requirements.

关 键 词：人类白细胞抗原 血小板特异性抗原 基因多态性 血小板输注无效 血小板供者资料库 

分 类 号：R457.11[医药卫生—治疗学]