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目的探讨HPA基因多态性及其等位基因对血小板输注效果的影响。方法自2015年1月-2017年1月,连续性收集50例本院收治的血小板输注无效患者作为观察组,同期收集50例血小板输注有效的患者作为对照组,观察2组患者HPA基因多态性。结果与对照组比较,观察组患者供患双方HPA分型相合率显著降低(4.00%vs 82.00%,P<0.05);血小板恢复百分比显著降低[(11.91±3.23)%vs(31.56±7.38)%,P<0.05);血小板纠正增加指数显著降低(6.84±2.27 vs 16.38±1.92,P<0.05)。2组患者HPA等位基因(HPA1-6,9,15)均以纯合子aa为多见。但观察组HPA-2等位基因为aa、ab、bb的分别有37、8、5例,对照组分别有48、2、0例,差异有统计学意义(P<0.05);观察组HPA-3等位基因为aa、ab、bb的分别有33、9、8例,对照组分别有46、3、1例,差异有统计学差异(P<0.05)。观察组HPA-15等位基因为aa、ab、bb的分别有35、8、7例,对照组分别有47、2、1例,差异有统计学意义(P<0.05)。2组患者的血小板供者HPA等位基因(HPA1-6,9,15)均以纯合子aa为多见,差异均无统计学意义(P>0.05)。血小板输注无效患者HPA-2,3等位基因为aa、ab和bb的血小板恢复百分比、血小板纠正增加指数逐步下降(P<0.05)。结论血小板输注无效与HPA基因多态性有关,等位基因型b可能是导致血小板输注无效的原因。
Objective To investigate the effect of HPA gene polymorphism and its allele on the effect of platelet transfusion. Methods From January 2015 to January 2017, 50 consecutive patients with ineffective platelet transfusion in our hospital were collected as observation group. Fifty patients with platelet transfusion effective during the same period were enrolled as control group. HPA gene Polymorphism. Results Compared with the control group, the coincidence rate of HPA typing in the two groups was significantly lower (4.00% vs 82.00%, P <0.05), and the percentage of platelet recovery was significantly lower (11.91 ± 3.23% vs 31.56 ± 7.38% , P <0.05). The increase index of platelet correction was significantly lower (6.84 ± 2.27 vs 16.38 ± 1.92, P <0.05). HPA alleles (HPA1-6,9,15) in 2 patients were more common in homozygous aa. But the observation group HPA-2 allele for aa, ab, bb were 37,8,5 cases, the control group were 48,2,0 cases, the difference was statistically significant (P <0.05); observation group HPA -3 alleles for aa, ab, bb were 33,9,8 cases, respectively, the control group were 46,3,1 cases, the difference was statistically significant (P <0.05). There were 35, 8, and 7 cases of HPA-15 allele in observation group and 47,2,1 cases in control group respectively, the difference was statistically significant (P <0.05). The HPA alleles (HPA1-6,9,15) of platelet donors in both groups were all homozygous for aa, but the difference was not statistically significant (P> 0.05). HPA-2, 3 alleles in patients with ineffective platelet transfusion showed a percentage of platelet recovery of aa, ab, and bb, and a decrease in platelet augmentation index (P <0.05). Conclusion The ineffective platelet transfusion is related to the polymorphism of HPA gene. The allele b may be the cause of ineffective platelet transfusion.