HLA-Ⅱ类抗体引起输血相关性急性肺损伤——附2例报告  

Study on transfusion-related acute lung injury caused by HLA-Ⅱantibody

作　　者：邹玉 郑茂 纪欣[3] 廖秀云[2] 姜天华[1] 王珏[3] ZOU Yu;ZHENG Mao;JI Xin;LIAO Xiuyun;JIANG Tianhua;WANG Jue(Department of Blood Transfusion,Deyang People′s Hospital,Deyang 618000,China;Deyang Central Blood Station;Institute of Blood Transfusion,Chinese Academy of Medical Sciences&Peking Union Medical College)

机构地区：[1]德阳市人民医院输血科,四川德阳618000 [2]德阳市中心血站 [3]中国医学科学院北京协和医学院输血研究所

出　　处：《中国输血杂志》2023年第10期885-888,共4页Chinese Journal of Blood Transfusion

基　　金：成都中医药大学“杏林学者”医院专项(YYZX2022068);中国医学科学院医学与健康科技创新工程(2021-1-I2M-060)。

摘　　要：目的 探讨输血相关急性肺损伤(TRALI)发生的危险因素。方法 回顾性分析2例TRALI患者输血后的临床症状、体征、影像学检查及实验室检查结果,并对患者进行HLA基因分型及供者血浆HLA抗体分型检测。结果 2例患者输血后的临床表现和实验室检测指标符合TRALI诊断标准,临床及时给予呼吸支持治疗后均好转。献血者因妊娠后产生了高滴度的HLA-Ⅱ类抗体,其中包括可分别特异性识别患者HLA抗原的抗体。结论 1名女性献血者捐献的血小板输注后引起2例患者发生TRALI,均由HLA-Ⅱ类抗体导致。Objective To explore the risk factors of transfusion-related acute lung injury(TRALI).Methods The clinical symptoms,signs,imaging examinations,and laboratory test results of two patients with TRALI after blood transfusion were retrospectively analyzed,and human leukocyte antigen(HLA)genotyping of the patient and HLA antibodies typing of the plasma donors were performed.Results The clinical manifestations and laboratory parameters of two patients were consistent with those of TRALI after blood transfusion.After timely clinical respiratory support treatment,all patients were improved.Blood donors produced high titers of HLA-Ⅱantibodies after pregnancy,including antibodies that specifically recognize the patient′s HLA antigen.Conclusion Two patients developed TRALI after platelet transfusion from a female blood donor,which was caused by HLA-Ⅱantibodies.

关 键 词：输血相关急性肺损伤 血小板 HLA抗体 

分 类 号：R457.11[医药卫生—治疗学]