孕期血小板抗原抗体检测的研究进展

Research progress of platelet antigen antibody detection during pregnancy

大量研究发现妊娠与血小板抗体的产生有着密切的关系,孕妇孕期可能由于同种免疫性因素或自身免疫性因素产生抗血小板抗体,这些抗体可以通过胎盘屏障进入胎儿血液循环,与胎儿血小板结合发生抗原抗体反应,导致胎儿出现一系列血小板减少性出血性疾病,最终使孕妇出现早期流产、复发性流产或新生儿出现免疫性血小板减少症。新生儿同种免疫性血小板减少症是由于同种免疫性因素引发的新生儿出血性疾病,该病在高加索人群中的发病率约为0.1%,在日本人群中的发病率约为0.15%,但在我国目前尚没有这方面的统计数据,该病发病较急,可出现全身皮肤和脏器的广泛出血,严重者会出现颅内出血甚至死亡。因此孕期进行血小板抗原抗体检测有着重要的意义,它能够有效地探讨反复流产的病因、早期预测及预防新生儿同种免疫性血小板减少症的发生。目前血小板抗原抗体的检测技术主要包括血清学和分子生物学检测技术,国内外也相继出现了一系列更为先进的检测技术。本文从血小板抗原抗体的分类、血小板抗体的产生及致病机制、最新的血小板抗原抗体检测方法以及新生儿同种免疫性血小板减少症研究状况等多方面阐述了最新的研究进展,以便引起临床医生及孕妇的重视,为血小板抗原抗体检测在孕妇日常产检中的推广提供重要的参考依据。

Numerous studies have found that pregnancy has a close relationship with platelet antibody. Due to alloimmune or autoimmune factors, pregnant women may produce platelet antibodies, which can make their way through the placental barrier into fetal blood circulation and cause antigen antibody response combined with fetal platelet, which leads to a series of fetal thrombocytopenic hemorrhagic disease and eventually makes the pregnant women in early abortion, recurrent miscarriage or the newborn in immune thrombocytopenia. Neonatal alloimmune thrombocytopenia is a neonatal hemorrhagic disease caused by alloimmune factors. The incidence of this disease in Caucasian population is about 0.1%, and the incidence rate in Japanese population is about 0.15%, but there is no statistical data in China in this field. The disease is urgent, which can cause extensive hemorrhage in overall skin and organ. Serious case can appear intracranial hemorrhage or even death. Therefore, platelet antigen antibody detection during pregnancy is of great significance, which can efficiently explore the etiology of recurrent miscarriage, early predict and prevent the occurrence of neonatal alloimmune thrombocytopenia. At present, the detection technology of platelet antigen antibody mainly includes serology and molecular biology technology, and a series of advanced detection technology have been developed at home and abroad. This paper presents the latest research progress on the classification of platelet antigen antibody, the generation and pathogenesis of platelet antibodies, the latest detection methods of platelet antigen antibody, and the research status of neonatal alloimmune thrombocytopenia, in order to arouse the attention of clinicians and pregnant women, in order to provide important reference basis for promotion of platelet antigen antibody detection in pregnant women in daily prenatal.