中国汉族人群HPA分型单采血小板供者库的建立模式与库容

本研究探讨建立中国汉族人群HPA分型单采血小板供者库的模式和合适的库容水平。研究方法为合并分析公开发表的中国16个省份的汉族血小板献血者人群人类血小板抗原（human platelet antigen，HPA）分布多态性群体调查数据。对HPA多态性群体调查数据进行Hardy—Weinberg平衡检验。结果表明，HPA．1、-4、石、-10未检出bb纯合子，HPA-7-9，11-14、-16未检出b基因。HPA1-16系统相互独立存在于血小板表面。中国汉族人群中发现了648种HPA组合，其中42种频率高于0．001的组合的累积频率达0．9763，频率最高（0．2012）的组合为：HPA-（7-8-9-11-12-13-14—16）aa-（1-4-5-6-10）aa-2aa-3ab-15ab。HPA对偶抗原不配合概率高于0．1的系统有HPA．15、-3和-2，对偶抗原不配合概率介于0．01—0．1的系统有HPA-1、-5和-6。中国汉族人群供受者间随机输血HPA1—16系统对偶抗原全匹配概率为0．3195。根据库容（N）随频率（F）变化的曲线，推导得到在P=95％时的回归方程LogN=-0．4394x Ln（F）＋0．4324。使用该公式椎测综合频率（HPA和AB0的频率乘积）为0．005的库容至少需要为576．07人。结论：中国汉族人群HPA分型单采血小板供者库应采用单库容600名供者的区域多中心联合建库模式，它既能解决当地主要的HPA—15、3和2系统不配合造成的血小板输注无效（platelet transfusion refractoriness，PTR），还可以在遗传背景相近的区域有效地扩大建库规模以解决HPA低频抗原的不配合问题。在评估HpA分型血小板供者库容时不仅要考虑HPA的频率还同时要考虑ABO血型分布频率对库容的影响。

Mode and Size of HPA-Typed Plalelet Apheresis Donor Bank in Chinese Han Population

This study was purposed to determine the mode and size of human platelet antigens （HPA） typed platelet apheresis donor bank. The published data of HPA distribution collected from Chinese Han population of 16 provinces were analyzed. The combined data were tested with the Hardy-Weinberg equilibrium. The results showed that the bb homozygote was not detected in HPA-1, -4, 45, -10, and b gene was not found in HPA-7-9 ,11-14, -16. There were 648 combined HPA 1-16 genotypes in Chinese Han population, and the cumulative frequency of 42 combinations higher than 0. 001 were 0. 9763. The highest frequency （0.2012） in combination was HPA-（7 -8-9-11-12-13-14-16） aa - （ 1-4- 5-6-10） aa-2aa-3ab-15ab. The probability of HPA dual antigen mismatch in HPA-15, -3 and -2 was higher than the 0.1, and the probability in the HPA-1, -5, and -6 was between 0.01 - 0. 1. The probability of full-match in HPA1 - 16 antigens was 0. 3195 in Chinese Han population after the random blood transfusion. According to the curve drawn by donor number （N） versus frequency （F）, the regression equation LogN -- -0.4394 × Ln （F） ＋0.4324 was derived at P = 95%. If the derived frequency （ product of HPA frequency and ABO frequency） is 0.005, then the N should be 576.07 at least in Chinese Han population. It is concluded that the mode of regional, multi-center database of HPA-typed platelet apheresis donor bank may be acceptable in Chinese Hart population, and the suitable number of HPA-typed platelet donor in one bank may be 600. Therefore, the bank can be used to treat the platelet transfusion refractoriness （PTR） caused by HPA-15, 3 and 2 mismatch mainly, and can be expanded effectively in similar genetic background to deal with the low-frequency HPA antigens mismatch. The number of HPA-typed platelet apheresis donor influences not only on the frequency of HPA, but also on the frequency of ABO group.