摘要
目的探讨解决血小板输注无效的途径,改善血小板输注效果。方法对36例血小板输注无效患者先进行HLA抗体与HPA抗体检测,然后分别在血小板供者库中找到HLA-I类位点3个以上抗原相合的供者,进行血小板交叉配合试验。结果365例PTR患者中HLA抗体和HPA抗体检出阳性率分别为75.0%和8.3%,HLA与HPA联合抗体检出阳性率为16.7%。对27例仅有HLA抗体的患者选择HLA-类位点3个以上抗原相合的供者,其血小板输注有效率为96.3%,对3例有HPA抗体的患者采用血小板交叉配合试验,其血小板输注有效率为100.0%。对6例有HLA与HPA联合抗体的患者,选择HLA-类位点3个以上抗原相合的供者,进行血小板交叉配合试验,其血小板输注有效率为67.3%。结论对PTR患者进行抗体筛查,选择HLA相合的供血者及血小板交叉配合试验十分重要,是解决PTR的有效途径。
Objective To inquiry the approach resolving platelet transfusion refractoriness（PTR）,improve the efficacy of platelet transfusion. Methods Antibody of HLA and HPA were first detected in thirty-six patients with PTR,then more than 3 alleles compatible donors on HLA class I from the platelet donor bank were found and carried through platelet cross-matching tests. Results The positive rate of HLA antibody in patients was 75.0% ,the positive rate of HPA antibody was 8.3% and the positive rate of HLA antibody combined with HPA antibody was 16.7%. For twenty-seven patients with HLA antibody only,more than 3 alleles compatible donors on HLA class I from the platelet donor bank, the efficacy rate of platelet transfusion was 96.3 %, For three patients with HPA antibody, platelet cross-matching test were adopted, and the efficacy rate of platelet transfusion was 100.0%. For six patients with HLA antibody and HPA antibody, more than 3 alleles compatible donors on HLA class I from the platelet donor bank were found and carried through platelet cross-matching tests, the efficacy rate of platelet transfusion was 67.3%. Conclusion It is very important to carry out antibody screening, select platelet donor for HLA compatible and platelet cross-matching tests. It is an effective approach for solving PTR.
出处
《临床输血与检验》
CAS
2009年第2期126-128,共3页
Journal of Clinical Transfusion and Laboratory Medicine
作者简介
张献清（1965-），男，湖南安乡人，副教授，博士，主要从事临床输血研究，（Tel）029-84773670。
