血小板相关抗体与血小板输注效果的关系探讨

目的探讨血小板相关抗体与血小板输注效果的关系。方法采用简易致敏血小板血清学技术（SEPSA）检测79例多次输血患者的血小板相关抗体,在血小板输注前后监测血小板计数,并计算1h和24h血小板增高指数（CCI）,输注无效者进行血小板交叉配型后再行配合性输注,分析配合性输注效果。结果47例检测出血小板抗体阳性,占59．5％,抗体阳性组输注后1h和24h的CCI均显著低于阴性组（t=2．462、2．583,均P〈0．05）;阳性组有40例输注无效,无效率为85．1％,显著高于阴性组（x^2=34．46,P〈0．05）;配型成功组输注后1h和24h的CCI均显著高于不成功组（t=2．152、2．230,均P〈0．05）;配型成功组有27例输注有效,有效率为87．1％,显著高于不成功组（x^2=4．34,P〈0．05）。结论血小板相关抗体的产生可导致血小板输注无效,采用血小板配合性输注能较好地解决问题。

Correlation between platelet-associated antibody and platelet infusion effects

Objective To investigate the correlation between platelet-associated antibody and platelet infusion effects.Methods SEPSA was used to detect the platelet-associated antibody of 79 patients with multiple transfusions of platelet,the platelet count before and after platelet infusion was monitored and the corrected count increment (CCI) in lh and 24h were calculated,for those judged to be ineffective platelet infusion,the platelet cross-matching was first done and then received matching infusion again and the infusion effects were analysed. Results 47 cases were detected with platelet antibody positive in 79 patients,accounting for 59.5％ ,the CCI of lh and 24h after infusion in platelet antibody positive group were significantly lower than the negative group, the difference was statistically significant( t = 2. 462、2. 583, all P ＜ 0. 05 ) ;40 cases in positive group had the invalid with the invalid rate of 85.1％which was significantly higher than the negative group, the difference was statistically significant ( x2 = 34. 46, P ＜0. 05 ) ;the CCI of 1h and 24h after infusion in matching success group were significantly higher than the unsuccessful group, the difference was statistically significant( t = 2. 152、2. 230, all P ＜ 0. 05) ;27 cases in matching success group had the effective infusion with the effective rate of 87. 1％ ,which was significantly higher than the unsuccessful group, the difference was statistically significant ( x2 = 4. 34, P ＜ 0. 05). Conclusion The production of anti-platelet antibody was a major immune factor which lead to platelet transfusion refractoriness ,the blood platelet cooperative infusion could be a good solution for the platelet transfusion refractoriness.