血小板相关抗体检测及血小板交叉配型的临床应用

Clinical Application of Platelet Relative Antibody Determination and Platelet Crossmatch

目的探讨酶联免疫竞争抑制法的临床应用效果及血小板交叉配型对血小板输注效果的影响。方法采用ELISA法对临床确认的特发性免疫性血小板减少症(ITP)104例、系统性红斑狼疮(SLE)27例、甲亢43例、非免疫性血小板减少症(NATP)23例及正常对照80例进行检测,同时检测104例ITP和80例正常对照的网织血小板(RP);采用简易致敏红细胞血小板血清学技术(SEPSA)对部分血小板相关抗体阳性病例进行血小板交叉配型。结果各种免疫性血小板减少症患者PAIg阳性率较高,与正常对照组相比差异有显著性(P<0.05),非免疫性血小板减少组与免疫性血小板减少组相比,前者阳性率及各项指标增高不明显。104例ITP患者和正常对照组的RP分别为(13.6±5.2)%、(3.8±1.1)%,差异有显著性(P<0.05)。对30例血小板相关抗体阳性且输注无效的患者进行血小板配型输注,其中25例相合,有效率为83%。结论血小板相关抗体检测具有一定的临床诊断价值,血小板配型可有效提高临床输注效果。

Objective To explore the clinical application with ELISA and effect of platelet transfusion with platelet crossmatch. Methods 104 ITP,27 SLE,43 hyperethyreosis, 23 NATP and 80 normal contrast were detected by ELISA. Meanwhile RP were detected by flow cytometry in ITP and normal contrast. Crossmatch approach was used to screen compatible platelet for some patients with platelet relative antibody positive. Results Various kinds of immunity platelet-penia has higher positive rates in PAIg than those in normal controls（P〈0. 05）. The positive ratio and various kinds of indexes were lower in non-immunity platelet-penia growps than those in immunity platelet-penia growps. The RP were （13.6± 5.2）% and （3.8±1.1）% in 104 ITP patients and normal controls. There was significant difference（P〈0. 05）. 30 cases were selected to use crossmatch ,with platelet relative antibody positive and refractoriness to platet transfusion,and the effective rate was 83%. Conclusions Detection of platelet relative antibody has diagnosis value. Platelet crossmatch can raise the effect of clinical transfusion.