血小板抗体检测对多次输血后血小板输注无效患者的临床价值

目的探讨血小板抗体检测对多次输血后血小板输注无效患者的临床价值。方法回顾性分析2018年3月至2019年3月期间我院收治的130例经多次输血后血小板输注无效患者的临床资料,分析血小板同种抗体与人类白细胞抗原(HLA)、人类血小板抗体(HPA)的阳性率和特异性,并分析血小板抗体阳性率与输血次数、输入血液成分的关系。结果输血次数为2~3次患者的血小板抗体阳性率显著低于4~5次患者与>5次患者(P<0.05)。输注机采血小板患者的血小板抗体阳性率显著高于输注悬浮红细胞患者与输注少白细胞悬浮红细胞患者(P<0.05)。血小板输注无效患者的同种HLA抗体阳性率为46.15%,同种HPA抗体阳性率为25.38%,血小板自身抗体阳性率为13.85%。结论多次输血后血小板输注无效的患者中,同种HLA抗体最多,其次为HPA抗体,最少的是血小板自身抗体;血小板抗体阳性率随输血次数的增加而升高,且与输入血液成分密切相关。

Clinical Value of Platelet Antibody Detection in Patients with Platelet Transfusion Refractoriness After Repeated Blood Transfusion

Objective To explore the clinical value of platelet antibody detection in patients with platelet transfusion refractoriness after repeated blood transfusion.Methods The clinical data of 130 patients with platelet transfusion refractoriness after repeated blood transfusion in our hospital from March 2018 to March 2019 were analyzed retrospectively.The positive rate and specificity of platelet alloantibody,human leukocyte antigen(HLA)and human platelet antibody(HPA)were analyzed.The relationships of the positive rate of platelet antibody with the number of transfusion and components of transfused blood were analyzed.Results The positive rate of platelet antibody in patients with 2~3 times of blood transfusion was significantly lower than that in patients with 4~5 times of blood transfusion and patients with more than 5 times of blood transfusion(P<0.05).The positive rate of platelet antibody in patients with transfusion of apheresis platelets was significantly higher than that in patients with transfusion of suspension red blood cells and patients with transfusion of red blood cells in leukocytes-reduced suspension(P<0.05).The positive rate of HLA isoantibodies,the positive rate of HPA isoantibodies and the positive rate of platelet autoantibody of patients with platelet transfusion refractoriness were 46.15%,25.38%and 13.85%respectively.Conclusions In patients with platelet transfusion refractoriness after repeated blood transfusion,HLA isoantibodies is the most,HPA isoantibodies was the second,and the platelet autoantibody was the least.The positive rate of platelet antibody increases with the increase of times of transfusions,and is closely related to the composition of the transfused blood.