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目的探讨HLA-Ⅰ类配型血小板输注在造血干细胞移植和血液病患儿血小板减少时提高血小板输注的疗效。方法在5例造血干细胞移植患儿和3例急性白血病患儿骨髓抑制期血小板输注无效时输注HLA-Ⅰ类半相合/相合血小板,以24h血小板校正计数指数(CCI)、判定输注效果。结果8例进行HLA-I类配型血小板输注的患儿中,HLA-I类半相合或1个位点不合血小板输注者7例,共提供HLA-Ⅰ类半相合血小板输注者43例次;HLA-Ⅰ类全相合血小板1例,共提供HLA-Ⅰ类全相合血小板2例次。4例为父母供者,共提供10例次血小板输注,24hCCI值为18.24±2.45;4例为非血缘关系供者,共提供35例次血小板输注,24hCCI值为8.78±1.47;父母供者血小板输注后24hCCI值明显高于非血缘关系供者。8例患儿血小板配型输注前后24hCCI自身对照,差异均有显著统计学意义(P<0.01)。结论对于血小板无效输注的造血干细胞移植和血液病患儿,输注HLA-Ⅰ类半相合/相合血小板可明显增强血小板输注的疗效,尤其以直系亲属供者更明显。
Objective To investigate the effect of HLA-Ⅰ type platelet transfusion on platelet transfusion in hematopoietic stem cell transplantation and thrombocytopenia in children with hematologic diseases. Methods HLA-Ⅰ haploidentical / concomitant platelets were infused in 5 children with hematopoietic stem cell transplantation and 3 children with acute leukemia during myelosuppression. The platelet count (CCI) was used to determine the infusion effect . Results Of the 8 children who received HLA-I type platelet transfusion, 7 were HLA-I haploidentical or 1-site non-platelet transfusion recipients, providing HLA-I haplobled 43 A case of HLA-Ⅰ fully co-platelet in 1 case, provided a total of HLA-Ⅰ class Ⅱ co-platelets. 4 patients were parents and provided 10 cases of platelet transfusion for 24hCCI value of 18.24 ± 2.45; 4 patients were non-blood donors, providing a total of 35 cases of platelet transfusion, 24hCCI value of 8.78 ± 1.47; parents for 24hCCI value after platelet transfusion was significantly higher than that of non-blood relationship donor. The differences of 24hCCI self-control in 8 children before and after platelet transfusion were statistically significant (P <0.01). Conclusion In patients with hematopoietic stem cell transplantation and hematologic diseases with ineffective platelet transfusion, infusion of HLA-Ⅰ haploidentical / coincident platelets can significantly enhance the efficacy of platelet transfusion, especially in immediate relatives.