血小板抗体检测在肿瘤患者血小板输注中的应用

Application of platelet antibody detection in tumor patients with platelet transfusion

目的探讨肿瘤患者血小板抗体产生及输注效果的影响因素。方法采用Galileo-Neo全自动血型仪及Capture-P Ready Screen试剂盒对输注血小板的患者进行输注前、输注后血小板抗体检测,并观察输注疗效。结果143例输血小板患者中,血小板抗体阳性57例,阳性率39.9%;输注有效110例,有效率76.9%。单因素分析性别、年龄、血小板输注次数和配型血小板使用对血小板抗体产生有影响（P〈0.05）;血小板抗体对血小板输注效果有影响（P〈0.05）。多因素logistic回归分析显示,男性（OR=2.524,95%CI 1.143-5.574）、血小板输注次数（血小板输注≥5次相比1次,OR=5.554,95%CI 2.296-13.434;血小板输注≥5次相比2次,OR=3.300,95%CI 1.297-8.397）对血小板抗体产生有影响（P〈0.05）;血小板抗体对其输注效果有影响（P〈0.05）。结论肿瘤患者血小板抗体产生与多种因素有关,减少输注次数,能够降低抗体的产生;同时,避免血小板抗体的产生能够提高输注效果。

Objective To investigate the effect of anti-platelet antibodies production and effectiveness of platelet transfusion in tumor patient. Methods Galileo-Neo automatic blood analyzer and Capture-P Ready Screen kit were used to detect anti-platelet antibodies before and after platelet transfusion for the patients, and the effectiveness was observed. Results Among 143 patients with platelet transfusion, there were 57（39.9%） cases with anti-platelet antibodies positive, and 110（76.9%） effective cases. The single-factor analysis found that sex, age, platelet transfusion times and platelet with crossmatch types had effect on anti-platelet antibodies production （P 〈 0.05）. The result of anti-platelet antibodies produc- tion had effect on the platelet transfusion effectiveness （P 〈 0.05）. Logistic analysis of multiple variables showed that sex （OR=2.524, 95% CI 1.143-5.574）, platelet transfusion times（≥5 times compared to 1 time, OR=5.554, 95% CI 2.296-13.434; ≥5 times compared to 2 times, OR=3.300,95% CI 1.297-8.397） had effect on anti-platelet antibodies production （P 〈 0.05）. The result ofplatelet antibodies production had effect on the platelet transfusion effectiveness （P 〈 0.05）. Conclusion Anti-platelet antibodies formation in tumor patients is related to a variety of factors. Reducing platelet transfusion times can reduce the production of anti-platelet antibodies. Avoiding platelet antibodies formation can improve trans- fusion effectiveness.