中山地区血小板抗体及特异性分布调查  

Distribution of platelet antibodies and their specificity in Zhongshan area

作　　者：林惠燕 吴泳伦 孙爱农 方育如 陈前英 李乔 王玉珏 王红梅[2] 杨志钊[3] 简晓毅 许先国[5] 段生宝[2] LIN Huiyan;WU Yonglun;SUN Ainong;FANG Yuru;CHEN Qianying;LI Qiao;WANG Yujue;WANG Hongmei;YANG Zhizhao;JIAN Xiaoyi;XU Xianguo;DUAN Shengbao(Zhongshan Blood Center,Zhongshan 528400,China;Suzhou Institute of Biomedical Engineering and Technology;Zhongshan People's Hospital;Zhongshan Boai Hospital;Zhejiang Provincial Blood Center)

机构地区：[1]中山市中心血站,广东中山528400 [2]中国科学院苏州生物医学工程技术研究所 [3]中山市人民医院 [4]中山市博爱医院 [5]浙江省血液中心

出　　处：《中国输血杂志》2024年第1期63-67,共5页Chinese Journal of Blood Transfusion

基　　金：中山市社会公益与基础研究项目(2020B1065);国家卫健委科研项目(WKJ-ZJ-2021)。

摘　　要：目的了解广东中山地区无偿献血者及患者血小板抗体发生频率,研究血小板抗体特异性和交叉配型。方法利用固相免疫吸附法(SPIA)对献血者及患者血小板抗体进行筛查,流式细胞术(FCM)进行复查,Pak-Plus酶免法进行抗体特异性鉴定,并采用SPIA模拟血小板交叉配型。结果共检测献血者标本1049份,患者标本598份,SPIA筛查阳性分别为6(0.57%)份vs 49(8.19%)份(P<0.05);SPIA检测阳性标本中,献血者FCM、酶免法复查阳性符合率100%,患者FCM复查阳性符合率95%,酶免法阳性符合率88%;献血者初筛阳性标本中,5份为抗-HLAⅠ占83%,1份为抗-CD36占17%(人群发生率为0.10%)。14份酶免阳性患者标本中,2份抗-GPⅡb/Ⅲa,1份抗-GPⅠa/Ⅱa,8份抗-HLAⅠ,3份为混合抗体(HLAⅠ和GPⅡb/Ⅲa、GPⅠa/Ⅱa),按抗体种类计算,HLAⅠ抗体最多,占65%(11/17),其次为与HPA相关的抗-GP占35%(6/17)。血小板抗体阳性配型率低于30%的患者占多数,为71.4%(10/14)。结论中山地区患者血小板抗体阳性率明显高于无偿献血者,多为抗-HLAⅠ、抗-GP,抗-CD36发生率极低,因此应建立已知血小板抗原供者库,同时应开展患者血小板抗体检测及其配型,有助于解决临床血小板输注无效的问题。Objective To investigate the frequency of platelet antibodies in voluntary blood donors and patients in Zhongshan,Guangdong Province,and to study the specificity and cross-matching of platelet antibodies.Methods Platelet antibodies of blood donors and patients were screened by solid-phase immunoadsorption(SPIA),rechecked by flow cytometry(FCM),and antibody specificity was identified by PakPlus enzyme immunoassay,and platelet crossmatching was simulated by SPIA.Results A total of 1049 blood donor samples and 598 patient samples were tested,with 6(0.57%)and 49(8.19%)samples positive for SPIA,respectively(P<0.05);In SPIA positive samples,the positive concordance rate of FCM in blood donors and patients was 100%vs 95%,and that of enzyme immunoassay was 100%vs 88%.Among the initial screening positive samples of blood donors,5 were anti-HLAⅠantibodies,accounting for 83%,and 1 was anti CD36 antibody,accounting for 17%,with an incidence rate of 0.10%.Among the 14 samples of enzyme immunoassay positive patients,2 were anti-GPⅡb/Ⅲa,1 was anti-GPⅡa/Ⅱa,8 were anti HLAⅠ,and 3 were mixed antibodies(HLAⅠ,GPⅡb/Ⅲa,GPⅠa/Ⅱa).According to the types of antibodies,HLAⅠantibodies were the most common,accounting for 65%(11/17),followed by HPA related anti GP,accounting for 35%(6/17).The majority of patients had a platelet antibody positive typing rate below 30%,accounting for 71.4%(10/14).Conclusions The positive rate of platelet antibody of patients in Zhongshan area is significantly higher than that of voluntary blood donors,and most of them are anti-HLAⅠand anti-GP,and the incidence of anti-CD36 is extremely low.Therefore,it is necessary to establish a known platelet antigen donor bank,and at the same time,carry out platelet antibody testing and matching of patients,which is helpful to solve the issue of platelet transfusion refractoriness.

关 键 词：血小板抗体 血小板输注无效 抗-CD36 无偿献血者 血小板交叉配型(PXM) 

分 类 号：R457.11[医药卫生—治疗学]