血小板免疫抗体检测及交叉配型在提高血小板输注效果中的应用  

The Application of Platelet Immunoantibody Detection and Cross Matching in Improving the Effect of Platelet Transfusion

作　　者：庄丽碧[1] 林小晶 ZHUANG Libi;LIN Xiaojing(Department of Blood Transfusion,the Second Hospital of Fuzhou,Fuzhou 350000,China;Department of Blood Transfusion,Zhangzhou Hospital Affiliated to Fujian Medical University,Zhangzhou 363000,China)

机构地区：[1]福州市第二医院输血科,福建福州350000 [2]福建医科大学附属漳州市医院输血科,福建漳州363000

出　　处：《中国医药指南》2023年第35期68-71,共4页Guide of China Medicine

摘　　要：目的观察血小板免疫抗体检测及交叉配型应用于血小板输注,对其输注效果的影响。方法选取2019年1月至2021年12月在福州市第二医院收治的220例血小板输注患者,按照随机数字表法1:1配对原则分为观察组(n=110)、对照组(n=110),对照组给予常规同型血小板输注,观察组采用固相凝固法行血小板相关免疫球蛋白(PAIg)检测,依据检测结果,PAIg检测阴性患者给予同型血小板输注,PAIg检测阳性患者行交叉配型后,选择相容血小板输注,对比两组血小板输注前、输注1 h、24 h后血小板参数[平均血小板体积(MPV)、血小板比积(PCT)、血小板计数(PLT)、血小板分布宽度(PDW)]、血小板计数增加指数(CCI)、凝血功能[凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)]、血小板输注有效率、非溶血性输血反应发生率。结果输注1 h、24 h后观察组PCT、PDW、MPV、PLT均较对照组高(均P<0.05);观察组血小板输注1 h、24 h后CCI水平均较对照组高(均P<0.05);输注1 h、24 h后观察组TT、PT、APTT均较对照组短(均P<0.05);观察组输注有效率高于对照组,发热、寒战、皮疹等非溶血性输血反应发生率低于对照组(均P<0.05)。结论血小板PAIg抗体检测及交叉配型可有效改善血液病患者血小板状态,调节机体凝血功能,提高输注有效率,且具有一定安全性。Objective To observe the effect of platelet immunoantibody detection and cross-matching on platelet infusion.Methods 220 patients with platelet transfusion admitted to our hospital from January 2019 to December 2021 in the Second Hospital of Fuzhou were selected and divided into observation group(n=110)and control group(n=110)according to the 1:1 pairing principle of random number table method.Plateletassociated immunoglobulin(PAIg)test was performed by solid phase coagulation in the observation group.According to the test results,patients with negative PAIg test were given homologous platelet infusion,while patients with positive PAIg test were given compatible platelet infusion after cross-matching.The two groups were compared before,1 h and 24 h after platelet infusion,platelet parameters[mean platelet volume(MPV),platelet ratio(PCT),platelet count(PLT),platelet distribution width(PDW)],platelet count increase index(CCI),coagulation function[thrombin time(TT),activated partial thrombin time(APTT),prothrombin time(PT)],platelet transfusion Incidence of effective injection and non-hemolytic transfusion reactions.Results 1 h and 24 h after infusion,PCT,PDW,MPV and PLT in the observation group were higher than those in the control group(all P<0.05).The CCI level of the observation group was higher than that of the control group 1 h and 24 h after platelet infusion(all P<0.05).After 1 h and 24 h infusion,TT,PT and APTT in the observation group were shorter than those in the control group(all P<0.05).The effective rate of infusion in the observation group was higher than that in the control group.The incidence of non-hemolytic transfusion reactions such as fever,chills and rash was lower than that in the control group(all P<0.05).Conclusions Platelet PAIg antibody detection and cross matching can effectively improve the platelet status of patients with blood diseases,regulate the coagulation function of the body,improve the efficiency of infusion,and have a certain safety.

关 键 词：免疫抗体 血小板 交叉配型 固相凝固法 血小板相关免疫球蛋白 

分 类 号：R457.1[医药卫生—治疗学]