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目的观察多次输血的血液病患者血小板抗体与血小板输注效果的关系。方法观察46例血液病患者98例次输注血小板后的输注效果,并通过血小板纠正计数指数(CCI)指标进行评价。血小板抗体采用简易致敏红细胞血小板血清学试验(SEPSA)法进行检测并通过淋巴毒试验和磷酸氯喹试验鉴定抗体特异性。结果血小板无效输注率为42.9%;98例次血小板输注后的血清标本中,血小板抗体阳性者39例,阳性率为39.8%;HLA抗体阳性者无效输注率为69.7%,HPA抗体阳性者及HLA和HPA抗体阳性者无效输注率均为100.0%。血小板抗体阳性者的血小板无效输注率为74.4%(29/39),明显高于血小板抗体阴性者的22.0%(13/59)(P<0.01)。结论血小板抗体检测及抗体类型的确认,配合性地输注血小板,有利于提高血小板输注的有效性。
Objective To observe the relationship between platelet antibodies and platelet transfusion in patients with multiple blood transfusions. Methods A total of 98 cases of hematological diseases were observed after transfusion of platelet transfusion and evaluated by platelet count correction index (CCI). Platelet antibodies were detected by the simple sensitized erythrocytic platelet serological test (SEPSA) and the antibody specificity was determined by lymphotoxin test and chloroquine phosphate assay. Results The rate of invalid platelet transfusion was 42.9%. Among the serum samples collected from 98 cases of platelet transfusion, 39 cases were positive for platelet antibodies, the positive rate was 39.8%. The invalid infusion rate of HLA antibody positive was 69.7% Infectious rates of both HLA and HPA positive patients were 100.0%. The platelet invalid infusion rate was 74.4% (29/39) in patients with positive platelet antibodies, which was significantly higher than that in platelets negative patients (22.0%, 13/59) (P <0.01). Conclusion The detection of platelet antibodies and the identification of antibody types, with the platelet transfusion, will help to improve the effectiveness of platelet transfusion.