血液病患者血小板抗体检测与血小板输注效果的临床分析

Analysis of platelet antibody detection and its effect on platelet transfusion in patients with hematologic disease

目的:探讨血液病患者血小板抗体的产生对血小板输注疗效的影响。方法:监测血液病患者单采血小板输注前后外周血小板计数,同时采用固相凝集法进行血小板抗体筛查,以24h血小板回收率(PPR)和血小板计数增高指数(CCI)判断血小板输注效果,并分析血小板输注无效(PTR)的影响因素。结果:40例血液病患者血小板输注无效率为27.5%(11/40);输注无效患者中血小板抗体阳性检出率为63.64%(7/11);血小板抗体阳性组的输注无效率(58.33%)高于抗体阴性组的输注无效率(14.29%),两者比较差异有统计学意义(χ2=6.11,P<0.05)。结论:血小板抗体的产生是导致血液病患者血小板输注无效的主要因素,血小板抗体的及时检出可预测和阻止PTR的发生,提高患者血小板输注的有效性。

Objective：To investigate platelet antibody detection and its effect on platelet transfusion in patients with hematologic disease.Method：Platelet count of the patients with hematologic disease was monitored before and after platelet transfusion,and platelet antibody was screened with Solid-phase coombs test kit.Percentage platelet recovery（PPR） and corrected count increment（CCI） at 24 hours were used to evaluate the efficiency of platelet transfusion,and to the influencing factors of platelet transfusion refractoriness（PTR）were analyzed.Result：The PTR rate was 27.5% in 40 cases of patients with hematologic disease,The positive rate of platelet antibodies was 63.64%.There was a significant difference in the efficiency of platelet transfusion between the antibody positive group and the negative group（χ2=6.11,P0.05）.Conclusion：Platelet antibody is the main immune factor causing PTR.Clinicians should avoid or decrease the occurrence of PTR so as to increase the efficiency of platelet transfusion by detecting platelet antibody.