血小板输注无效患者血小板特异性糖蛋白抗体表达的实验研究

Experimental study on expression of anti-platelet glycoprotein specific antibody in the platelet transfusion refractoriness patient

目的探讨血小板输注无效(PTR)患者血小板特异性糖蛋白抗体的表达情况。方法采用ELISA方法检测56名临床上确诊为PTR患者的血小板特异性糖蛋白抗体、应用PCR方法检测其血小板特异性抗原(HPA)1-6,15基因分型。结果 56名PTR患者检出血小板特异性糖蛋白抗体,8例表达阳性(占14.3%),包括血小板特异性糖蛋白GPⅡb/Ⅲa阳性7例,GPⅠa/Ⅱa阳性1例、GPⅠb/Ⅰx阳性1例、GPⅣ阳性1例。结合8例患者的抗体检测反应格局和HPA抗原基因型结果分析抗体的特异性为:4例存在抗-HPA3b、3例存在抗-HPA3a、1例存在抗-HPA5b。结论反复输血的血小板输注无效患者,应选择HPA抗原相匹配的血小板供者,以改善血小板输注效果。

Objective To investigate the expression of anti-platelet glycoprotein specific antibody in the platelet transfusion refractoriness patients.Methods 56 platelet transfusion refractoriness patients were studied.platelet-specific glycoprotein antibody were detected with ELISA.HPA1-6,15 genotypes were detected with PCR.Results 56 PTR patients in all,anti-platelet glycoprotein specific antibody in 8cases were positive.Respectively,7cases were GPⅡb/Ⅲa antibody positive;1cases were GPⅠa/Ⅱa antibody positive;1cases were GPⅠb/Ⅰx antibody positive;1cases were GPⅣ antibody positive.After analyze platelet glycoprotein specific antibody and patients＇ HPA genotypes,there are 4cases anti-HPA3 b,4cases anti-HPA3 aand 1cases anti-HPA5 b.Conclusion About these platelet repeated transfusion refractoriness patient,the Donor whose HPA antigen match to patient should be chosen to improve the transfusion effect.