血小板血型抗体在母婴免疫反应中的研究

Studies of Platelet-specific Alloantibody on Feto-maternal Alloimmunity

应用简易致敏红细胞血小板血清学技术（SEPSA）对1201例正常孕妇和52例早期流产患者的母婴免疫血小板同种抗体进行了研究,显示早期流产妇女的血小板抗体阳性率为21.15％。显著高于正常孕妇（3.66％）及经产妇（1.37％）血小板抗体与早期流产的发病有显著相关性（X^2=29.32,P<0.005）。血小板抗体免疫球蛋白类型为IgG型,仅1例又有IgM型,以血小板特异性抗体与HLA抗体并存者占人多数（54.54％）。在查出的55例血小板抗体阳性孕妇中有6例发生新生儿同种免疫性血小板减少性紫癜症（NAITP）,并证实HPA-5b（Br~α）抗体是引起我国NAITP的主要抗体。我们对其中3例抗体效价高于1:32的孕妇进行血浆党换治疗,有效地防止了血小板减少性紫癜及早期流产的发生。

The simplified sensitized erythrocyte platelet serology assay (SEPSA) was used to screen and analyse the feto-maternal platelet specific alloantibodies. The studies on 1201 cases of normal pregnant women and 52 patients with early abortion showed that the incidence of the platelet-specific alloantibodies in pregnant women with early abortion was 21. 15%, significantly higher than that of normal pregnant women (3. 66%) and that of parous women (1. 37%), This incidence of alloantibodies correlated significantly with that of the onset of early abortion. All the antibodies belonged to IgG type of immunoglobulin with one exception that was IgM type. Most of platelet-specific alloantibodies accompanied with HLA antibodies (54. 54%). Six out of 55 pregnant women with positive platelet-specific alloantibodies developed neonatal alloimmune thrombocytopenic purpura (NAITP). The main type of antibody causing NAITP in China was anti-Bra (HPA-5b). Three cases of pregnant women with antibody titres above 1 : 32 were treated with plasma exchanges. This manoeuvre effectively prevented the development of thrombocytopenic purpura and early abortion.