中国组织工程研究

中国组织工程研究 ›› 2022, Vol. 26 ›› Issue (24): 3875-3879.doi: 10.12307/2022.569

• 干细胞基础实验 basic experiments of stem cells • 上一篇    下一篇

沈阳地区血小板输注无效患者的抗体检测与交叉配型结果分析

王宏阳，李晓丰，周助人，李函频，丛日娇，李剑平   

  1. 辽宁省血液中心输血医学研究所，辽宁省沈阳市   110044
  • 收稿日期:2021-07-21 接受日期:2021-09-08 出版日期:2022-08-28 发布日期:2022-01-24
  • 通讯作者: 李剑平，博士，主任医师，辽宁省血液中心输血医学研究所，辽宁省沈阳市 110044
  • 作者简介:王宏阳，女，1991年生，辽宁省辽阳市人，汉族，2018年遵义医科大学毕业，硕士，检验师，主要从事输血医学研究。 李晓丰，女，1976年生，辽宁省鞍山市人，汉族，2008年中国医科大学毕业，硕士，主任技师，主要从事输血医学研究。
  • 基金资助:
    辽宁省自然基金资助计划项目(2020-MS-354)，项目负责人；李晓丰；沈阳市科技计划项目(19-112-4-067)，项目负责人；李晓丰；沈阳市中青年科技创新人才支持计划项目(RC190179)，项目负责人；李晓丰；沈阳市卫生健康委科研课题(2020095)，项目负责人；王宏阳

Antibody detection and cross-matching results in patients with ineffective platelet transfusion in Shenyang region

Wang Hongyang, Li Xiaofeng, Zhou Zhuren, Li Hanpin, Cong Rijiao, Li Jianping   

  1. Liaoning Blood Center Institute of Transfusion Medicine, Shenyang 110044, Liaoning Province, China
  • Received:2021-07-21 Accepted:2021-09-08 Online:2022-08-28 Published:2022-01-24
  • Contact: Li Jianping, MD, Chief physician, Liaoning Blood Center Institute of Transfusion Medicine, Shenyang 110044, Liaoning Province, China
  • About author:Wang Hongyang, Master, Laboratorian, Liaoning Blood Center Institute of Transfusion Medicine, Shenyang 110044, Liaoning Province, China Li Xiaofeng, Master, Chief technician, Liaoning Blood Center Institute of Transfusion Medicine, Shenyang 110044, Liaoning Province, China
  • Supported by:
    Natural Foundation Project of Liaoning Province, No. 2020-MS-354 (to LXF); Shenyang Science and Technology Plan Project, No. 19-112-4-067 (to LXF); Shenyang Young and Middle-Aged Science and Technology Innovation Talent Support Project, No. RC190179 (to LXF); Scientific Research Project of Shenyang Municipal Health Commission, No. 2020095 (to WHY)

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摘要：

文题释义：
血小板输注无效：是指患者在连续2次输注ABO血型相合且足够剂量的血小板悬液后仍处于无反应状态，即血小板计数未见显著升高，临床出血倾向未见减轻。
血小板抗原系统：分为两类，一类是血小板非特异性抗原，即血小板与其他细胞或组织共有的抗原，包括HLA-1抗原、ABH抗原、Le及P抗原等；另一类是血小板特异性抗原(human platelet antigen，HPA)。

背景：随着血小板输注的广泛应用，血小板输注无效患者呈逐年增多的趋势。
目的：通过对血小板输注无效患者的血小板抗体和交叉配型情况进行检测分析，为血小板输注无效患者提高输注效果提供参考依据。
方法：选取2020年4-12月期间112例血小板输注无效患者，使用血小板抗体检测试剂盒(固相凝集法)进行血小板抗体检测及交叉配型实验。
结果与结论：①血小板抗体检测结果：112例患者中有103例血小板抗体检测结果为阳性，阳性率高达92%；②血小板交叉配型结果：有25例患者在交叉配型实验中与供者的血小板均不相合，有18例患者与所有供者的血小板均相合；③血小板抗体检测结果与配型率的关系：血小板抗体检测结果为阴性的血小板配型率为84%、血小板抗体检测结果为1+，2+，3+，4+的血小板配型率分别为75.4%，71.6%，54.6%，27.6%，各组之间差异有显著性意义(P < 0.05)；④血小板抗体阳性率与患者多次送检的关系：血小板输注次数<2次和≥2次的血小板抗体阳性率分别为90.2%和94.2%，差异无显著性意义(P > 0.05)；⑤输注配型血小板对患者配型率的影响：在送检次数相同的各组中，初次送检配型率与重复送检配型率差异无显著性意义(P > 0.05)；在所有重复送检的患者中，初次送检与重复送检的平均配型率分别为41.2%和50.6%，差异无显著性意义(P > 0.05)；⑥结果表明，血小板抗体检测结果阳性程度越高其配型率越低，患者在输注配型相合血小板后血小板抗体阳性强度未体现有增强的趋势，得到了稳定的输注效果，血小板抗体的准确检测以及输注配型相合血小板对于提高血小板输注疗效具有重要的临床价值。

https://orcid.org/0000-0002-5392-0471 (李剑平)；https://orcid.org/0000-0002-3888-6359 (李晓丰)

中国组织工程研究杂志出版内容重点：干细胞；骨髓干细胞；造血干细胞；脂肪干细胞；肿瘤干细胞；胚胎干细胞；脐带脐血干细胞；干细胞诱导；干细胞分化；组织工程

关键词: 血小板输注, 血小板输注无效, 血小板抗体, 血小板交叉配型

Abstract: BACKGROUND: With the widespread use of platelet transfusion, patients with ineffective platelet transfusion are increasing year by year.
OBJECTIVE: To provide a reference for improving the effect of platelet transfusion in patients with ineffective platelet transfusion by detecting and analyzing platelet antibody and cross-matching.
METHODS: The platelet antibody test kit (solid phase agglutination method) was used to detect platelet antibody and cross-matching test in 112 patients with ineffective platelet transfusion from April to December 2020.
RESULTS AND CONCLUSION: (1) The results of platelet antibody test were positive in 103 of 112 cases. The positive rate was as high as 92%. (2) The results of the platelet cross-matching type showed that 25 patients were incompatible with the donor’s platelets in the cross-matching experiment, and 18 patients were matched with all the donor’s platelets. (3) Relationship between platelet antibody test results and matching rate: The results of platelet antibody test were 84% in patients with negative platelet antibody test, 75.4%, 71.6, 54.6%, and 27.6% in patients with 1+, 2+, 3+, and 4+ platelet antibody test. Differences between groups were statistically significant (P < 0.05). (4) Relationship between the positive rate of platelet antibodies and the patients’ multiple examinations: The positive rate of platelet antibody was 90.2% and 94.2% in the number of platelet transfusions < twice and ≥ twice (P > 0.05). (5) Effect of platelet infusion on the patient’s matching rate: In each group with the same number of inspections, there was no statistically significant difference in the matching rate between the initial inspection and repeated inspections (P > 0.05). In all patients with repeated inspections, the average matching rates of the initial inspection and repeated inspections were 41.2% and 50.6%, respectively, and the difference was not statistically significant (P > 0.05). (6) These results suggest that the higher the positive degree of platelet antibody test, the lower the matching rate was. The positive intensity of platelet antibody did not show an increasing trend after infusion of matched platelets. The patient obtained a stable transfusion effect. Accurate detection of platelet antibody and infusion of matched platelets have an important clinical value for improving the efficacy of platelet transfusion.

Key words: platelet transfusion, ineffective platelet transfusion, platelet antibodies, platelet cross-matching

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