摘要
目的 探讨佛山地区血小板输注无效（PTR）患者血小板（PLT）抗体特异性、抗体阳性率及其相关因素,为制定PLT输注策略提供参考依据.方法 选择2012年1月至2013年8月,佛山地区5所医院收治的55例PTR患者作为研究对象（本研究遵循的程序符合各病例收集医院人体试验委员会制定的伦理学标准,得到该委员会批准,并征得受试对象的知情同意,并与之签订临床研究知情同意书）.采用固相凝集法检测PTR患者血清中的PLT抗体.计算PLT同种抗体检出率和人类白细胞抗原（HLA）、人类血小板抗原（HPA）抗体阳性率,并分析年龄和输血次数对PLT抗体阳性率的影响.结果 PTR患者PLT同种抗体检出率为58.2％ （32/55）,其中同种HPA抗体阳性率为21.8％ （12/55）,同种HLA抗体阳性率为50.9％（28/55）,抗-HLA占所有免疫性抗体的87.5％ （28/32）;在检出HPA抗体的患者中有66.7％（8/12）的患者同时检出HLA抗体.PLT自身抗体阳性率为7.3％（4/55）.女性患者中PLT抗体阳性率为60.61％（20/33）,略高于男性的54.5％（12/22）,但两者比较差异无统计学意义（x2=0.01,P＞0.05）.PLT抗体阳性率随输血次数增加而呈增高趋势（x2趋势=13.14,P＜0.05）,以输血次数为4～6次时增幅最大.结论 佛山地区PTR患者中PLT同种抗体以HLA抗体多见,其次为HPA抗体,少数患者还存在PLT自身抗体;PLT同种抗体阳性率随输血次数增加呈增高趋势,而与患者性别无关.
Objective To detect and determine the correlation factors,specificity and positive rate of platelet （PLT）-reactive antibodies in patients who were refractory to platelet transfusions （RPT） in Foshan area,and to provide a reference basis for formulating marketing strategy of PLT transfusions.Methods From January 2012 to August 2013,55 RPT patients who were inspected by five different hospitals in Foshan area were included in this study.The study protocol was approved by the Ethical Review Board of Investigation in Human Being of these five hospitals.Informed consent was obtained from all participants.Serum samples of these patients were screened with solid-phase agglutination method for PLT-reactive antibodies.The incidence of platelet-reactive antibodies,human leukocyte antigen （HLA）antibodies,human platelet antigens （HPA） antibodies were calculated.Statistical analysis of the correlation factors of the incidence of PLT-reactive antibodies were accomplished.Results Detection rate of PLT-reactive antibodies in RPT patients was 58.2% （32/55）.The incidence of HLA antibodies was 50.9% （28/55）,accounting for 87.5% （28/32） of serum with PLT isoantibodies.The HPA isoantibodies were found in 21.8% （12/55） serum,of which 66.7% （8/12） occurred together with anti-HLA.The PLT-reactive autoantibodies were found in 7.3% （4/55） serum.PLT-reactive antibodies were detected more in female （20/33） than in male （12/22） with a frequency of 60.6% and 54.5%,respectively.But there was no statistical significant difference between female and male patents（x2=0.01,P〉0.05）.The frequency of occurrence of PLT-reactive antibodies increased along with the number of blood transfusion（x2tramd =13.14,P〈0.05）.The greatest increase appeared when the number of blood transfusion were four to six times.Conclusions The PLT-specific antibody in PTR patients is not rare,although isoantibodies are predominantly anti-HLA in Foshan area.Autoantibodies are detected in a few PTR patients.The frequency
出处
《国际输血及血液学杂志》
CAS
2014年第3期193-196,共4页
International Journal of Blood Transfusion and Hematology
基金
佛山市医学类科技攻关项目（201208069）
