80名血小板抗体初筛阳性患儿的抗体鉴定与分析

Antibody identification and analysis of 80 children with positive platelet antibody in initial screening

目的 探讨分析血小板抗体初筛阳性患儿的血小板抗体分布与类型。方法 对本院2021年9月—2022年5月临床申请输注血小板且血小板抗体筛检为阳性的80例患儿标本,采用PAKPLUS试剂盒进行抗体鉴定,分析患儿HLA和HPA抗体分布情况。结果 80例初筛阳性患儿标本中,检测出9例阴性,其余71例阳性中,HLA-Ⅰ类抗体阳性1例1.41%(1/71),HPA抗体阳性21例29.58%(21/71),HLA-Ⅰ类抗体和HPA抗体均阳性49例69.01%(49/71);70例HPA抗体阳性中,单一HPA抗体17例23.95%(17/71),其中抗-GPⅡb/Ⅲa 13例18.31%(13/71),抗-GPⅠa/Ⅱa 2例2.82%(2/71),抗-GPⅣ2例2.82%(2/71),抗GPⅠb/Ⅸ0例0%(0/71),多个HPA抗体同时存在53例74.65%(53/71)。比较年龄、性别、输血史和疾病类型中的抗体分布,无统计学差异。结论 血小板抗体阳性患儿中血小板抗体以HLA-Ⅰ类抗体合并HPA抗体为主,HPA抗体中抗GPⅡb/Ⅲa抗体占比最大。抗体分布与年龄、性别、输血史及疾病类型无关。

Objective To explore the distribution and types of platelet antibodies in children with positive platelet antibody in initial screening.Methods Blood samples of 80 pediatric patients who applied for platelet transfusion in our hospital from September 2021 to May 2022 and tested positive for platelet antibodies were identified using the PAKPLUS kit for antibody identification,and the distribution of HLA and HPA antibodies were analyzed.Results Among the 80 reactive samples in initial screening,9 were negative,71 were positive.Among the 71 positive cases,1 was HLA-Ⅰantibody positive(1.41%,1/71),21 were HPA antibody positive(29.58%,21/71),and 49 were both HLA-Ⅰ antibody and HPA antibody positive(69.01%,49/71).Among the 70 HPA positive cases,23.95%(17/71) had a single HPA antibody,with 18.31%(13/71) of anti GP Ⅱb/Ⅲa,2.82%(2/71) of anti GP Ⅰa/Ⅱa,2.82%(2/71) of anti GP Ⅳ and 0%(0/71) of anti GP Ⅰb/Ⅸ,while 74.65%(53/71) presented multiple HPA antibodies.No statistically significant difference was found in antibody distribution among age,gender,transfusion history and disease types.Conclusion HLA-Ⅰ antibody combined with HPA antibody are the main types of platelet antibodies among children with positive platelet antibodies.Anti-GPⅡb/Ⅲa accounted for the largest proportion of HPA antibodies.Antibody distribution is not releted to age,gender,history of blood transfusion and disease types.