单采血小板滤除白细胞后输注效果临床研究

目的分析单采浓缩血小板滤除残余白细胞后在临床输注血小板治疗的效果。方法测定应用滤除白细胞前输注血小板和滤除白细胞后输注血小板两组反复输注血小板病人的HLA抗体和HPA抗体,评价滤除白细胞后输注血小板的输注效果。结果应用滤除白细胞前反复输注血小板患者,HLA抗体阳性率61.11%(22/36),HPA抗体阳性率11.11%(4/36),其中4例同时检出HLA抗体和HPA抗体,发生血小板输注无效17例;应用滤除白细胞后输注血小板,反复输注血小板患者,HLA抗体阳性率13.89%(5/36),HPA抗体阳性率11.11%(4/36),其中3例同时检出HLA抗体和HPA抗体,发生血小板输注无效3例。应用前后两组比较,HLA抗体和HPA抗体阳性率有显著性差异(P<0.05),血小板输注有效率也有显著性差异(P<0.05)。结论血小板滤除白细胞后输注,可以降低患者血小板HLA抗体和HPA抗体同种免疫的发生率,尤其是血小板HLA抗体同种免疫的发生率,显著提高了临床血小板输注治疗效果。

Objective Assay the clinical therapeutic effect of concentrated platelets Iransfusion after filtering out leucocytes. Methods Detect the anti- HLA and anti-I-IPA of the two groups＇ patients which are grouped by before and after filtering out leucocytes＇ and repeated platelet transfusion, then calculate the effect of filtering out leucocytes＇ platelet transfusion. Results The group that not filter out leucocyte, its positive rate of anti-HLA is 61.11%（22/36）, anti- HPA is 11.11（4/36）, and 4 samples＇ anti-HLA and anti-HPA are both positive, 17 samples＇ platelets transfusion are invalid; The other group＇s positive rate of anti- HLA is 13.89%（5/36）, anti-I-IPA is 11.11%（4/36）, and 3 samples＇anti-HLA and anti-HPA are both positive, 4 samples＇ platelets transfusion are invalid. Analysis the two group＇s data, the positive rate of anti-HLA and anti-I-IPA are significantly different（P〈 0.05）, the effective rate of platelet transfusion is also significantly different（P〈 0.05）. Conclusion After filtering out leucocyte, the platelet transfusion can decrease the alloimmune rate of anti-HLA and anti-HPA, expecially the former, increase the efficiency of clinical platelet transfusion.