输注人免疫球蛋白对ITP患者输血相关性传染病检测指标的影响

The effect of infusion of Human Immunoglobulin in patients with ITP on the detection index of blood transfusion related infectious disease

目的研究18例原发免疫性血小板减少症(ITP)患者输注静注人免疫球蛋白(IVIG)后抗体水平变化,探讨输注IVIG对患者抗体水平的影响。方法以2016年1月—2017年7月12家医院合计18例ITP患者为研究对象,采用ELISA法,分别检测上述患者输注IVIG前和输注IVIG后d14—d28、d80—d90乙肝病毒5项、丙肝病毒抗体、梅毒抗体以及艾滋病毒抗体水平变化;若抗体检测结果为阳性,采用核酸检测技术进一步确认。结果18例患者输注IVIG14d后,抗-HBs效价显著升高,输注IVIGd80—d90,抗-HBs虽有降低,但和输注前相比,仍处于较高水平,仅有少部分患者恢复至输注前水平,显示不同患者对被动转移的抗-HBs代谢能力差异明显。结论短期内大剂量输注IVIG会引起ITP患者抗体水平升高,提示对IVIG输注患者进行抗体被动转移的排除具有重要意义。

Objective To study the change of antibody level in 18 patients with immune thrombocytopenia( ITP) after infusion Human intravenous immunoglobulin( IVIG) and investigate the effect of IVIG on antibody level of patients.Methods From January 2016 to July 2017 in 12 hospitals,18 cases of ITP patients as the research object,used the ELISA method to detect the change of five items of hepatitis B virus,hepatitis C virus antibody,syphilis antibody and HIV antibody level in these patients with infusion of IVIG before and after IVIG infusion for 14 to 28 days,80 to 90 days; if the antibody level was positive used nucleic acid detection technology to confirm by further. Results 18 cases of patients with infusion of IVIG for14 days,the anti-HBs titers were significantly increased; after infusion of IVIG 90 days,anti-HBs titers decreased,but it was still at a high level compared with that before infusion. Only a few patients can recover to the level before infusion,which showed that the metabolic ability of patients to the passive transfer of anti-HBs was obvious difference.Conclusion High doses infusion of IVIG in the short term may increase the antibody level in patients with ITP,suggesting that it is important to exclude the passive transfer of antibodies in patients undergoing IVIG infusion.