免疫性血小板输注无效预防策略研究进展  

Research progress on prevention strategies for immune platelet transfusion refractoriness

作　　者：赵沛喆 徐熠 梁雅珺 李卿 周源 许先国[2] ZHAO Peizhe;XU Yi;LIANG Yajun;LI Qing;ZHOU Yuan;XU Xianguo(Taiyuan Blood Center,Taiyuan 030024,China;Zhejiang Blood Center,Hangzhou 310052,China)

机构地区：[1]太原市血液中心,山西太原030024 [2]浙江省血液中心,浙江杭州310052

出　　处：《中国输血杂志》2025年第3期448-454,共7页Chinese Journal of Blood Transfusion

基　　金：中国输血协会威高科研基金重点项目(CSBT-MWG-202301);太原市科技局项目(ZC2024004);太原市医学重点学科(基础输血学);太原市医学科技创新平台(血液安全及资源利用科技创新平台)。

摘　　要：血小板输注无效(PTR)是血液病和肿瘤患者常见的问题。本文综述了免疫性PTR的诊断标准、影响因素,以及近年来的预防和管理策略。诊断标准通常涉及输注后血小板增量(PI)、血小板恢复率(PPR)和血小板校正计数增量(CCI)。免疫因素和非免疫因素均可能导致PTR,其中免疫因素主要包括HLA和HPA抗体。预防和管理策略包括使用去白细胞血小板、HLA和HPA抗原匹配血小板、静脉注射免疫球蛋白疗法以及免疫抑制策略等。尽管已有多种策略被提出并应用于临床实践,但免疫性PTR的预防和管理仍面临挑战。未来的研究需探索更有效的个体化防治策略,同时考虑新兴技术如纳米技术在输血领域的应用潜力。Platelet transfusion refractoriness(PTR)is a common issue among patients with hematological diseases and tumors.This article reviews the diagnostic criteria,influencing factors,and recent prevention and management strategies for immune PTR.The diagnostic criteria typically involve post-transfusion platelet increment(PI),platelet recovery rate(PPR),and corrected count increment(CCI).Both immune and non-immune factors can lead to PTR,with immune factors mainly including HLA and HPA antibodies.Prevention and management strategies include the use of leukocyte-reduced platelets,HLA and HPA antigen-matched platelets,intravenous immunoglobulin therapy,and immunosuppressive strategies.Although various strategies have been proposed and applied in clinical practice,the prevention and management of im-mune PTR remain challenging.Future research needs to explore more effective individualized treatment strategies,while also considering the potential application of emerging technologies such as nanotechnology in the field of transfusion.

关 键 词：血小板输注无效 免疫性因素 诊断标准 预防策略 

分 类 号：R457.1[医药卫生—治疗学] R331.143[医药卫生—临床医学]