摘要
目的检测血液病[白血病、再生障碍性贫血、特发性血小板减少性紫癜(ITP)、骨髓增生异常综合征)]患者血清中的血小板抗体,探讨其与血小板输注疗效的关联,并分析血小板抗体产生的相关影响因素。方法用固相凝集法检测158例血液病患者输注前血小板抗体,同时用全自动血细胞分析仪检测每次血小板输注前及输注后24h血小板计数,计算出实际血小板回收率(PPR),结合输注血小板后出血表现是否得到改善来判断输注疗效,分析血小板抗体与血小板输注疗效的相关性,并根据病因、患者性别、输注次数及血小板种类分别分组,对血小板抗体阳性检出率进行统计学分析。结果①158例血液病患者血小板输注总有效率为53.16%,血小板抗体总阳性检测率为17.72%;②血小板输注有效组抗体阳性率(5.95%)远低于输注无效组(31.08%)(P<0.05);③不同病因组患者血小板抗体阳性率比较,差异有统计学意义(P<0.05),其中ITP组抗体阳性率最高(34.38%),白血病组最低(8.86%);④血小板抗体的产生与性别无相关性(P>0.05);⑤不同血小板输注次数组间血小板抗体阳性率比较,差异有统计学意义(P<0.05),且随着输注次数增多,血小板抗体阳性率增高;⑥不同种类血小板组的抗体阳性检出率比较,单采组(8.77%)低于浓缩组(22.77%)(P<0.05)。结论①血小板抗体的产生与血小板输注疗效密切相关,血小板抗体是直接影响血小板输注效果的重要免疫因素之一;②血液病患者的病因与血小板抗体的产生有一定相关性;③血小板抗体的产生与患者性别无关;④血小板输注次数与血小板抗体产生密切相关;⑤血小板抗体的产生与输注的血小板种类有关,单采组明显低于浓缩组。
Objective To detect platelet antibody in the blood serum of patients with hematopathy [leukemia,aplastic anemia,idiopathic thrombocytopenic purpura （ITP）,myelodysplastic syndrome] and explore the correlation on platelet antibody detection and effect of platelet transfusion and analyze related influence factors of platelet antibody produc- tion. Methods The platelet antibody in 158 patients with hematopathy were detected by solid-phase agglutination method before platelet transfusion,at the same time,platelet count were detected with the automatic blood cell analyzer before platelet transfusion and after 24 hours transfusion every time,then the effect of platelet transfusion were evaluated according to percentage platelet recovery （PPR） calculated and whether bleeding performance have been improved or not after platelet transfusion,the correlation between platelet antibody and the effect of platelet transfusion was ana- lyzed,patients were grouped according to the etiology,gender,number of infusions and platelet species and the total positive detection rate of platelet antibody were analyzed statistically. Results ①The total effective rate of platelet transfusion in 158 patients witlr hematopathy was 53.16% and the total positive detection rate of platelet antibody was 17.72%;②The positive rate of platelet antibody in platelet transfusion effectiveness group（5.95%） was much less than the transfusion ineffectiveness group （31.08%） （P〈0.01）;③The positive rate of platelet antibody was compared in the different etiology group and the positive rate of ITP group is highest （34.38%） while the luekemia group is lowest （8.86%） and there was a statistical difference between the two groups above-mentioned; ④There is no correlation be- tween sex and production of platelet antibody （P〉0.05）; ⑤The positive rate of platelet antibody was compared in the different platelet transfusion frequency groups and there was a statistical difference （P 〈 0.05）,and it increased along
出处
《中国当代医药》
2013年第22期82-84,86,共4页
China Modern Medicine
基金
贵州省科技计划课题研究项目(黔科合LS字[2011]006号)
贵阳市科技计划项目(筑科合同[2011103]41号)
关键词
血液病
血小板抗体
血小板输注效果
Hematopathy
Platelet antibody
Effect of platelet transfusion
