血小板抗体检测及交叉配型在降低临床血小板输注无效中的作用

Role of platelet antibody detection and cross-matching in reducing ineffective platelet transfusion

目的:探讨血小板抗体检测及交叉配型在血小板输注效果中的作用。方法:采用固相凝集法观察多次输注血小板患者与无输血住院患者的血小板抗体阳性率,比较血小板抗体对输注效果的影响,并对血小板抗体阳性的患者进行血小板交叉配型输注,计算24 h CCI值来评价血小板输注效果。结果:试验组和对照组血小板抗体检测阳性率分别是47.6%和11.7%,差异有统计学意义(P<0.05),并且试验组血小板抗体阳性率与输注次数呈正相关。79例血小板抗体阳性患者血小板输注有效率和24 h CCI值明显低于阴性组,差异有统计学意义(P<0.05)。血小板配型相合组和不合组在血小板输注后24 h CCI值差异有统计学意义(P<0.05)。结论:多次输注血小板患者易产生血小板抗体,对血小板抗体检测阳性的患者进行交叉配型,可有效提高血小板临床输注效果。

Objective:To investigate the effect of platelet antibody detection and cross-matching on platelet infusion.Method:The positive rate of platelet antibody in patients with multiple transfusion platelets and inpatients without transfusion was observed by solid phase coagulation method.The effect of platelet antibody on the effect of infusion was compared,and the platelet cross-matching infusion was performed in patients with positive platelet antibody.Calculate 24 h CCI value to evaluate platelet infusion effect.Result:The positive rate of platelet antibody in the experimental group and control group was 47.6%and 11.7%respectively,the difference was statistically significant(P<0.05),and the positive rate of platelet antibody in the experimental group was positively correlated with the frequency of infusion.The effective rate of platelet transfusion and 24 h CCI in 79 patients with positive platelet antibody were significantly lower than those in the negative group,and the difference was statistically significant(P<0.05).The difference of 24 h CCI after platelet infusion was statistically significant between the platelet matching group and the unmatched group(P<0.05).Conclusion:Multiple transfusion of platelet is easy to produce platelet antibody,and cross-matching of patients with positive platelet antibody test can effectively improve the clinical transfusion effect of platelet.