血小板谱抗原的建立及其在鉴定血小板特异性抗体中的应用

Establishment of platelet antigen panel and its application in the identification of platelet specific antibodies

目的建立血小板谱抗原，鉴定引起血小板输注无效和新生儿血小板减少性紫癜的血小板特异性抗体，为血小板血型研究和临床治疗提供依据。方法根据中国人群人类血小板同种抗原（HPA）-1-HPA-16等位基因频率分布资料，利用聚合酶链反应．序列特异引物（PCR—SSP）技术对0型血小板供者进行HPA-1-HPA-6、HPA-15分型，筛选合适的供者，组成血小板谱抗原。通过建立的血小板谱抗原，利用简易致敏红细胞血小板血清学技术（SEPSA）鉴定同种免疫反应产生的血小板抗体的特异性。结果从O型血小板供者中筛选出11名供者，建立了血小板特异性抗体鉴定谱抗原。其可鉴定HPA-1～HPA-6，HPA-15抗体的特异性。在所筛检1120份样本中，有3例患者检出HPA抗体，其中HPA-4b（Penb）抗体1例，HPA-15a（Govb）抗体2例。结论通过血小板谱抗原鉴定血小板抗体的特异性，对提高临床输注血小板的安全性和有效性，以及预防新生儿血小板减少性紫癜有积极的意义。

Objective To establish the platelet antigen panel for identifying the specificity of platelet antibodies which cause platelet transfusion refractoriness and neonatal alloimmune thrombocytopenia and provide evidence for clinical therapy and platelet genotyping research. Methods Based on the frequency distribution of human platelet alloantigen （HPA）-1 to HPA-16 gene in China, the frequencies of HPA-1 to HPA-6,HPA-15 alleles in blood group O donors were genotyped by the polymerase chain reaction with sequence-specific primers （PCR-SSP） method, and suitable donors were chosen to establish platelet-specific antigen panel. Using the established platelet-specific antigen panel, the specificity of platelet antibodies caused by alloimmune reaction was identified by using simplified sensitized erythrocyte platelet serology assay （SEPSA）. Results Eleven platelet donors with blood group O were chosen to establish platelet-specific antigen panel which can identify specificity of HPA-1 to HPA-6, HPA-15 antibodies. One case of HPA-4b （Penb） and two cases of HPA-15a （Govb） platelet specific antibodies were detected in 1 120 samples. Conclusion Identifying the specific platelet antibodies using platelet specific antigen panel has profound significance on increasing the safety and effectiveness of clinical platelet transfusion and prevention of neonatal alloimmune thrombocytopenia.