血小板抗原基因分型与配型在血小板输注中的应用

Applications of Platelet Antigen Gene Typing and Matching in the Platelet Transfusion

本研究建立已知HPA基因型血小板供者库,开展相同HPA基因型血小板交叉配型后输注,防止血小板抗体的产生,解决血小板无效输注。应用PCR-SSP技术对血小板献血者和患者进行HPA基因分型,采集与患者ABO血型及HPA基因型相同血小板制剂,再加以固相凝集法配型相合后输注。结果表明,牡丹江地区HPA血型分布的遗传特征具有本地区人群特点,具有最高杂合度的是HPA-15,其次是HPA-3。采用ABO血型及HPA基因型均相同加固相凝集配型相合血小板输注有效率94.4%。采用ABO血型相同随机血小板固相凝集配型相合输注有效率77.8%。结论:牡丹江地区HPA血型分布的遗传特征具有多态性,采用血小板HPA同基因型供者采集加配型输注可防止血小板免疫性抗体及输注无效的发生,采用ABO同型随机血小板加配型输注是提高血小板输注的效果、防止输注无效发生的既经济又简便的方法。

The aim of this study was to establishment of known HPA genotype platelet donor data base and carry out the platelet antigen gene typing and matching in the platelet transfusion so as to prevent the production of the antibody and to avoid the platelet transfusion refractoriness.HPA of the donors and the patients were genotyped by PCR-SSP.The platelet transfusion with the same ABO type and HPA genotypes as the patient was selected and infused if the solid-phase agglutination matching was consistent.The results showed that the distribution of HPA types in Chinese Mudanjiang area had its own characteristics.HPA-15 had the greatest heterozygosity,and then HPA-3.The effective rate was 94.4％ if both the HPA types and the ABO types were coincident while the effective rate was 77.8％ when only ABO types were coincident.It is concluded that the distribution of HPA types in Chinese Mudanjiang area presents genetic polymorphism.The platelet transfusion with genetic typing and matching of both HPA and ABO types is an effective way to avoid production of the antibody and platelet transfusion refractoriness.