急性白血病患儿血小板输注状况与抗人类白细胞抗原-Ⅰ抗体抗人类血小板抗原抗体关系  

Relationship of platelet transfusion and detection yield of human leukocyte antigen-Ⅰ and human platelet antigen antibo-dies in children with acute leukemia

作　　者：洪星 陈思军 蔡敬芝 Hong Xing;Chen Sijun;Cai Jingzhi(Department of Clinical Laboratory,Shangrao Dongxin Fifth Hospital,Jiangxi 334000,China)

机构地区：[1]江西省上饶东信第五医院检验科,334000

出　　处：《实用医技杂志》2022年第10期1044-1047,共4页Journal of Practical Medical Techniques

摘　　要：目的分析急性白血病患儿抗人类白细胞抗原-Ⅰ(HLA-Ⅰ)抗体、抗人类血小板抗原(HPA)抗体检测与血小板输注状况的关系。方法回顾性分析上饶东信第五医院2020年1月至2022年1月接诊的84例急性白血病患儿作为研究对象。将84例急性白血病患儿根据其在治疗的过程中输注血小板的次数进行分类,分为输注1次、输注2次及输注≥3次。通过检测并对比分析不同输注血小板次数患儿的抗体检测结果、不同输注血小板次数患儿的输注效果、HLA-Ⅰ、HPA血小板抗体与输注效果的相关性。结果在84例白血病患儿中检测出抗体阳性患儿19例,阳性率为23%,其中HLA-Ⅰ抗体10例,HPA抗体9例。输注1次、输注2次、输注≥3次血小板患儿的阳性率分别为6%、30%、57%,差异有统计学意义(P<0.05);进一步分析可知,输注1次的阳性率低于输注2次的阳性率,输注2次的阳性率低于输注≥3次的阳性率,差异均有统计学意义(P<0.05);输注1次、输注2次、输注≥3次的无效率分为12%、35%、50%,两两相比,差异均有统计学意义(P<0.05);HLA-Ⅰ阳性抗体的输注无效率为62%,高于阴性抗体的18%,差异有统计学意义(P<0.05);HPA阳性抗体的输注无效率为67%,高于阴性抗体的19%,差异有统计学意义(P<0.05)。结论急性白血病患儿血小板HLA-Ⅰ抗体与HPA抗体的阳性率与血小板的输注次数有密切联系,且呈正相关,患儿血小板HLA-Ⅰ抗体与HPA抗体与血小板输注无效有关,且阳性抗体的输注无效率较高。Objective To investigate the association between detection yields for anti-human leukocyte antigen-Ⅰ(HLA-Ⅰ)and anti-human platelet antigen(HPA)and platelet transfusion in children with acute leukemia.Methods Retrospectively included as subjects were 84 children with acute leukemia admitted to Wuhu First People′s Hospital between January 2020 and January 2022.The 84 children with acute leukemia were stratified according to the number of platelet transfusion during their treatment(one,two,or≥3 sessions).The detection yield of antibodies in children with different number of platelet transfusion,and the treatment response to varied transfusion sessions in the children were compared.The correlation between HLA-Ⅰand HPA antibo-dies and the treatment response to platelet transfusion were investigated.Results Among 84 children with leukemia,19 tested positive for antibodies corresponding to a positive rate of 23%,including 10 positive for HLA-Ⅰand 9 for HPA antibodies.The antibody positivity rates in children with 1-,2-and≥3 platelet transfusion sessions were 6%,30%and 57%,respectively,with statistically significant difference(P<0.05).Further analysis showed that the antibody positive rate was significantly lower in children with one transfusion session than in those with two,and was significantly lower in children with two transfusion sessions than in those with three or more sessions(P<0.05).The rates of refractoriness in children with 1,2,and≥3 transfusion sessions were 12%,35%,and 50%respectively,with statistically significant difference by between-group comparison(P<0.05).The rate of refractoriness in HLA-I antibody positive children was 62%,which was significantly higher than that in HLA-Ⅰantibody-negative children(18%)(P<0.05).The rate of refractoriness in HPA antibody positive children was 67%,which was significantly higher than that in HPA antibody-negative children(19%)(P<0.05).Conclusion The positive rates of platelet-specific HLA-Ⅰand HPA antibodies in children with acute leukemia are clos

关 键 词：白血病 HLA抗原-Ⅰ抗体 输血 血小板 

分 类 号：R457.1[医药卫生—治疗学] R733.71[医药卫生—临床医学]