摘要
随着血小板输注量的逐年增长,相继产生的同种免疫性非溶血输血反应,甚至血小板输注无效已成为国内外临床极为棘手的问题。本文探讨了112例骨髓衰竭需长期输血小板的患者,产生同种抗体的比率为53.6％。其抗体为非血小板专有抗体,而属中国人高频HLA抗原的抗体,并证实HLA抗体是血小板输注无效的重要原因之一。对已产生抗体的部分患者再次输血小板前进行交叉配型,从任意献血者中选出相合的血小板混合输注,收到良好效果(P<0.01),这是目前解决血小板输注无效的有效方法。此外,推荐应用固相被动混合血凝法(MPHA)作为测定血小板抗体和血小板交叉配型的方法,其方法敏感性、特异性、重复性好,不需昂贵的设备。
As platelet transfusion was used more frequently.it is a sticky prohlem that it mduced non-hemolytic al-loimmunization reaction and led to platelet-unresponsiveness. This study investigated 112 patients with bone marrow failure needing repeated platelet transfusion. The incidence of induced alloantibody was 53. 6%. All antibodies associated were against HLA-specificity of Chinese higher frequency antigen and were non-specific platelet antibody. It was demonstrated that HLA-antibody was one of the reason of platelet-unresponsiveness. The platelet-unresponsive patients should have crossmatchmg before repeated piatelet transfusion, and the compatible platelet concentrates obtained from selection of random donors were transfused to the patients. It had a good effectualness(.P<0. 01). Therefore the platelet (.'rossmatchmg is an available method for platelet-unresponsiveness. The mixed passive haemagglutimn assay (MPHA) was used to determine platelet antibodies and crossmatching- MPHA is a test of high sensitivity .specificity and well reproductiveness.
出处
《天津医药》
CAS
1995年第11期645-649,共5页
Tianjin Medical Journal
关键词
输血
血小板输血
疗效
无效
免疫学
防治
platelet-unresporisiveness platelet crossmatching corrected count increment(CCI)
