血小板输注无效患者血小板抗体阳性的相关因素研究

Study on factors related to the ineffectiveness of platelet transfusion

目的研究血小板输注无效(PTR)患者输注血小板制品后血小板抗体的产生情况对其输注疗效的影响。方法采用固相凝集法和ELISA法对185例PTR患者进行血小板特异性和组织相关融性抗体检测及血小板膜糖蛋白抗体(抗-CD36抗体)检测,比较不同病种及不同性别的患者血小板抗体产生情况。结果185例PTR患者中检出血小板抗体阳性患者69例。不同血小板抗体种类PTR患者血小板抗体阳性率差异有统计学意义(χ^2=13.346,P<0.05),单一抗HLA-Ⅰ类抗体的PTR发生率最高,为15.7%。不同血液疾病种类PTR患者血小板抗体阳性率差异无统计学意义(χ^2=1.473,P>0.05)。不同性别PTR患者血小板抗体阳性率差异有统计学意义(χ^2=13.440,P<0.05),男性患者血小板抗体阳性率为26.17%,女性患者血小板抗体阳性率为52.56%。结论PTR患者血小板抗体阳性率与患者血小板抗体种类和患者性别有关,PTR患者应采用最匹配的血小板制剂输注,降低PTR的发生率,保证患者输血安全,有效节约血小板资源。

Objective To analyze the effect of platelet antibody production on platelet transfusion in patients with platelet transfusion refractoriness(PTR)in Xinjiang after platelet transfusion.Methods The platelet antibody screening and platelet membrane glycoprotein antibody(anti-cd 36 antibody)detection were performed in 185 patients with PTR by solid phase agglutination and ELISA,and the platelet antibody production in patients with different diseases and genders was compared.Results In 185 PTR patients,69 were positive for platelet antibody.There was significant difference in the positive rate of platelet antibody among different kinds of platelet antibody(χ^2=13.346,P<0.05).The highest incidence of PTR was 15.7%for single anti HLA-I antibody.There was no significant difference in the positive rate of platelet antibody in the PTR patients with different blood diseases(χ^2=1.473,P>0.05).The positive rate of platelet antibody in the PTR patients of different genders was statistically significant(χ^2=13.440,P<0.05).The positive rate of platelet antibody in male patients was 26.17%,and that in female patients was 52.56%.Conclusion The positive rate of platelet antibody in the PTR patients is related to the type of platelet antibody and the gender of patients.The most matching platelet preparation should be used for transfusion in the PTR patients to reduce the incidence of PTR,ensure the safety of transfusion and effectively save platelet resources.