摘要
目的观察人类血小板特异性抗原(human platelet alloantigens,HPA)1-6,9,15系统及其基因多态性与血小板输注无效(platelet transfusion refractoriness,PTR)的研究。方法选取40例血小板输注无效患者的外周血标本和供者标本,对其进行血小板特异性糖蛋白抗体检测,根据血小板回收率评判血小板输注效果,采用聚合酶链式反应(PCR)结合直接测序方法,对供、患者进行HPA1-6,9,15抗原系统基因进行分型,动态观察患者同型血小板输注后血小板恢复百分率(percent platelet recovery,PPR),探讨HPA基因多态性和血小板输注无效的关系。结果患者和供者HPA-1、4、9均未检测出HPA-b基因,呈呈aa纯合子单态性分布;HPA-5、6则主要以aa纯合子为多,较少看到bb纯合子。而HPA-2、3、15呈明显多态性分布,HPA-2、3、5、6、15等位基因频率均呈多态性分布。结论对反复多次发生血小板输注无效的患者,除需考虑HLA基因相关外,还与HPA基因多态性相关。在做HPA配型时,多数人只需检测供者与患者HPA2、3、15基因就可以显著减少血小板输注无效的发生。
Objective To research the clinical value between gene polymorphism of human platelet alloantigens（ HPA） 1-6,9,15 and platelet transfusion refractoriness（ PTR）. Methods Totally 40 patients with platelet transfusion refractoriness（ PTR） were randomly selected,and patients and donors＇ peripheral blood specimens were collected and tested these samples with platelet GP specific antibodies,and judged the results of platelet transfusion,and with the help of the combination of PCR and direct sequencing for classification of HPA 1-6,9,15 antigens and observe the percent platelet recovery（ PPR） after the same type of platelet transfusion, and explore the relationship between HPA gene polymorphism and PTR.Results There was no HPA-b gene was found neither on patients and donors＇ HPA 1,4,9,showed the distribution of aa homozygous form; HPA 5,6were mainly aa homozygous form,little bb homozygous form was discorvered. And HPA 2,3,15 were distributed of polymorphism,the frequency of HPA2,3,5,6,15 were found with polymorphism. Conclusion For these patients who were happened with PRT many times,in addition to taking HLA into account,HPA gene polymorphism are also need to be considered. Most people only need to test patients and donors＇ HPA2,3,15 gene to decrease the occurrence of PTR significantly when making HPA matching.
出处
《中国生化药物杂志》
CAS
2016年第4期173-175,共3页
Chinese Journal of Biochemical Pharmaceutics
基金
浙江省嘉兴市科技计划(2013AY21042-8)
关键词
血小板特异性抗原
基因多态性
血小板输注无效
血小板恢复百分率
human platelet allogntigens
gene polymorphism
platelet transfusion refractoriness
percent platelet recorvery
