血液病患者机采血小板无效输注与血小板抗体相关性的研究

Research on the correlation between the PTR and platelet antibody of the oatients suffering from HD

目的探讨血液病患者机采血小板无效输注（platelet transfusion resistance，PTR）与血小板抗体相关性。方法以计算血小板计数纠正增加指数（corrected count increment，CCI）作为PTR的量化的判断依据，观察207例的血液病患者进行机采血小板输注效果，并采用简易致敏红细胞血小板血清学技术（SEPSA）检测血小板抗体，计算PTR发生率及血小板抗体阳性率；将研究对象分为血小板抗体阳性组及血小板抗体阴性组，比较两组血小板输注效果及1hCCI、24hCCI值。结果PTR发生率为43．0％，血小板抗体阳性率为37．2％；血小板抗体阳性组与阴性组的PTR发生率差异具有统计学意义，（P〈0．01）；血小板抗体阳性组1hCCI及24hCCI明显低于血小板抗体阴性组，差异具有统计学意义，（P〈0．01）。结论血液病患者输注机采血小板前需进行血小板抗体的检测，对血小板抗体阳性患者进行血小板配型，有效地预防免疫性血小板无效输注的发生。

Objective To explore the correlation between the apheresis platelet transfusion resistance （PTR） and platelet antibody of the patients suffering from hematological diseases（HD）. Methods In the light of the corrected count increment（ CCI）, the effect of platelet transfusion among 207 cases patients who suffered from HD were observed, then the platelet antibody were detected by the use of SEPSA （ simplified sensitized erythrocyte platelet serology assay） and counting the occurrence of PTR and positive rate of platelet antibody. The patients were divided into positive platelet antibody group and negative platelet antibody group. The effects of platelet transfusion, 1 hCCI values and 24 hCCI values in two groups were compared. Results The PTR rate was 43.0% and positive rate of platelet antibody was 37. 2%. The PTR rates in positive platelet antibody group and negative platelet antibody group were absolutely different, which had statistical significance, （P 〈 0. 01 ）. The 1 hCCI and 24 hCCI values in the positive platelet antibody group was obviously lower than those in the neg- ative platelet antibody group, which also had statistical significance, （ P 〈 0.01 ）. Conclusion When the apheresis platelets transfusion is conducted on the HD patients, the platelet antibody detection and platelet typing for positive platelet antibody patients should be made, so as to effectively prevent the occurrence of immune platelet transfusion resistance.