HPA配型在免疫性血小板输注无效中的应用研究

目的探讨以HPA配型解决免疫性血小板输注无效的方案。方法 1)建立PCR-SSP方法检测HPA-1～5基因型检测方法,建立机采血小板供者库;2)采用微柱凝胶法和Capture-P法对32名血小板输血无效患者作血小板同种抗体筛查,并对2种方法比较;3)对血小板同种抗体筛查阳性患者采用已知HPA基因型的标准谱血小板作抗体鉴定并采取HPA基因型同型输注的原则寻找供者。结果 1)采用PCR-SSP方法成功检测出HPA-1～5基因型,并对1 000名血小板供者的HPA-1～5基因型定型;2)32例血小板输注无效病例中,微柱凝胶法检测血小板同种抗体阳性率为50%,Capture-P法血小板抗体阳性检出率为40%;3)32例血小板输血无效病例中2种方法同时血小板抗体阳性13例,其中2例鉴定为抗-HPA,分别为抗-HPA-5b(P=1/84)、抗-HPA-1a(P=1/55)。结论对抗-HPA引起的血小板输注无效患者采用HPA基因型相合的方法寻找供者是有效的。

Study of HPA-matched platelets in platelet transfusion refractoriness

Objective To explore the application of HPA-matched platelets in platelet transfusion refractoriness.Methods 1)To establish the SSP method of HPA-1～5 genotyping for human platelet antigens(HPA) matched platelet apheresis donor program.2) A total of 32 patients with platelet transfusion refractoriness were screened for platelet alloantibodies using the Micro column gel and Capture-P methods and the two methods were compared.3) For positive platelet alloantibody screens,antibody identification was performed using standard panel platelets and the patients were transfused with platelets from matched donors. Results 1)The SSP method of HPA-1～5 genotyping was established and 1 000 donors from apheresis platelet donor program were typed for HPA-1～5.2)The positive rates of Micro column gel and Capture-P methods were 50% and 40%.3)The positive results in both the Micro column gel and Capture-P methods was 13 and 2 of them were identified as HPA alloantibodies.There were HPA-5b(P=1/84)and HPA-1a(P=1/55). Conclusion The use of HPA-matched platelets in platelet transfusion refractoriness is effective.