哌拉西林钠他唑巴坦钠致药物性血小板减少症的实验室诊断研究  

Laboratory-based Diagnostic Investigation of Drug-induced Thrombocytopenia from Piperacillin-tazobactam Sodium

作　　者：马春娅[1] 张敏 付丽辉[1] 朱建玲 罗圆圆[1] 关晓珍[1] 于洋[1] MA Chunya;ZHANG Min;FU Lihui;ZHU Jianling;LUO Yuanyuan;GUAN Xiaozhen;YU Yang(The First Medical Center of PLA General Hospital,Beijing 100853;Hunan Provincial People's Hospital(The First Affiliated Hospital of Hunan Normal University),Changsha 410002)

机构地区：[1]解放军总医院第一医学中心,北京100853 [2]湖南省人民医院(湖南师范大学附属第一医院),长沙410002

出　　处：《临床输血与检验》2025年第2期191-195,共5页Journal of Clinical Transfusion and Laboratory Medicine

摘　　要：目的建立针对哌拉西林钠他唑巴坦钠致药物性免疫性血小板减少症(DITP)的检测流程,为临床及时诊断DITP提供依据。方法通过固相凝集法完成血小板抗体筛查检测,通过在固相凝集法检测体系中加入待检药物,完成哌拉西林钠他唑巴坦钠和奥美拉唑依赖的血小板药物抗体检测。通过体外红细胞致敏方法,应用抗人球蛋白法完成哌拉西林钠他唑巴坦钠依赖的红细胞药物抗体检测。对患者停药后1天、2天、5天和8天进行跟踪监测,以研究体内哌拉西林钠他唑巴坦钠依赖的血小板药物抗体强度和血小板计数变化趋势。结果患者使用哌拉西林钠他唑巴坦钠13天后,检出其体内存在哌拉西林钠他唑巴坦钠依赖的血小板药物抗体,该抗体导致患者血小板计数重度降低合并出血。结论固相凝集法血小板抗体筛查检测体系加入哌拉西林钠他唑巴坦钠,可用于该药物依赖性血小板抗体的快速诊断。Objective To establish a detection process for drug-induced immune thrombocytopenia(DITP)caused by piperacillin-tazobactam sodium,and to provide timely diagnostic criteria for clinical diagnosis of DITP.Methods Platelet antibody screening was conducted using the solid-phase agglutination method.The solid-phase agglutination method was employed in the detection system to test for piperacillin-tazobactam sodium and omeprazole dependent platelet antibodies.In vitro red blood cell sensitization was performed using the anti-human globulin method to detect drug antibodies against piperacillin-tazobactam sodium on red blood cells.The patients were followed up at 1,2,5,and 8 days post drug withdrawal to investigate the potency of piperacillin-tazobactam sodium-dependent platelet drug antibodies and observe trends in platelet counts.Results A patient who received piperacillin-tazobactam sodium for 13 days experienced a significant decrease in platelet count and developed bleeding symptoms,which were attributed to the presence of piperacillin-tazobactam sodium-dependent platelet drug antibodies.Conclusion The solid-phase agglutination method incorporating piperacillin-tazobactam sodium can be utilized as a rapid diagnostic tool for detecting drug-dependent platelet antibodies.

关 键 词：药物性免疫性血小板减少症 哌拉西林钠他唑巴坦钠 血小板抗体筛查 药物依赖性血小板抗体 

分 类 号：R978.1[医药卫生—药品] R558.2[医药卫生—药学]