摘要
目的探讨HPA-1—16基因多态性分布与血小板输注无效相关性。方法应用PCR-SSP法对上海地区268名汉族人群行HPA-1—16基因检测;应用ELISA法对49名反复输血的恶性血液病患者行血小板抗-HLA-Ⅰ与抗-HPA筛查试验。结果上海地区汉族人群HPA-1—16系统中,HPA-1—6,15系统等位基因频率1a=0.9889,1b=0.0111,2a=0.8881,2b=0.1119,3a=0.5989,3b=0.4011,4a=0.9963,4b=0.0037,5a=0.9907,5b=0.0093,6a=0.9832,6b=0.0168,15a=0.6418,15b=0.3582,均呈多态性分布;其余HPA-7—14,16系统等位基因均呈单线性分布。HPA-1,2,4—6,15系统主要以aa纯合子基因型频率分别为0.9776,0.7799,0.9925,0.9813,0.9664,0.4328。在HPA-2、3、15系统中出现bb纯合子基因型,其频率均为0.0037,0.1530,0.1492外,其余系统均未出现bb纯合子基因型。另外,在HPA-1—6,15系统中出现ab杂合子基因型,其频率分别为0.0224,0.2164,0.4963,0.0075,0.0187,0.0336,0.4180,以HPA-3杂合度最高,其次次序为HPA-15、HPA-2。在随机输血中,HPA不合发生率以HPA-3为最高(0.3650),其次分别为HPA-15(0.3541)、HPA-2(0.1790)。49名反复输血的恶性血液病患者中,有61.22%(30名)输血后相继出现抗-HLA-Ⅰ,而始终未检出抗-HPA。结论上海地区汉族人群血小板输注无效的主要原因是抗-HLA-Ⅰ所致;只需检测供者与受(患)者的HPA-2、-3、-15基因相合,就可基本达到血小板匹配性输注。
Objective To study the correlation between HPA-1--16 gene polymorphism distribution and platelet transfusion refractoriness. Methods HPA-1-16 genes were detected via PCR-SSP among 268 Han Chinese in Shanghai, and platelet HLA- I antibody and HPA antibody were screened by ELISA in 49 patients with malignant blood diseases who had received repeated blood transfusion. Results In HPA-I--16 systems of Hart Chinese in Shanghai, HPA-1-6,15 system allelic gene frequencies were 1a =0. 988 9,1b =0. 011 1,2a =0. 888 1,2b =0. 111 9,3a =0. 598 9,3b = 0. 401 1,4a = 0. 996 3 ,4b =0. 003 7 ,5a =0. 990 7 ,5b =0.009 3 ,6a =0. 983 2,6b =0. 016 8,15a =0. 641 8,15b=0.3582, all demonstrating polymorphic distribution. HPA-7-14, 16 system alleles demonstrated monomorphic distribution. The aa homozygnus genotype were most common in HPA-1,2,4-6,15 systems, with frequencies of 0.977 6, 0.779 9, 0.992 5, 0.981 3, 0.966 4, 0.432 8 respectively. And bb homozygous genotype was shown in HPA-2, 3, 15 systems with frequencies of 0. 003 7,0. 153 0,0. 149 2 respectively. No bb homozygous genotype was found in any other systems. In addition, ab heterozygous genotype was shown in HPA - 1-6,15 systems with frequencies of 0.022 4,0.216 4,0.496 3,0.007 5,0.018 7,0. 033 6,0.418 0, in which HPA-3 had the highest heterozygous level, followed by HPA-15, HPA-2. In random blood transfusion, HPA mismatch probability Was highest among HPA-3 （ 0. 365 0） ,followed by HPA-15 （0.354 1 ） and HPA-2 （ 0.179 0）. Among the 49 malignant blood disease patients with repeated blood transfusion, 61.22% （30 patients） produced anti- HLA- 1 , but none was tested positive for anti-HPA. Condusion Most platelet transfusion refractoriness among Han Chinese in Shanghai is caused by anti-HLA- I . Testing HPA-2, 3, 15 genes may be enough to match the HPA genes between donors and recipients before platelet transfusion.
出处
《中国输血杂志》
CAS
CSCD
北大核心
2009年第5期346-349,共4页
Chinese Journal of Blood Transfusion
