中国输血杂志2024,Vol.37Issue(1) :63-67.DOI:10.13303/j.cjbt.issn.1004-549x.2024.01.011

中山地区血小板抗体及特异性分布调查

Distribution of platelet antibodies and their specificity in Zhongshan area

林惠燕 吴泳伦 孙爱农 方育如 陈前英 李乔 王玉珏 王红梅 杨志钊 简晓毅 许先国 段生宝
中国输血杂志2024,Vol.37Issue(1) :63-67.DOI:10.13303/j.cjbt.issn.1004-549x.2024.01.011

中山地区血小板抗体及特异性分布调查

Distribution of platelet antibodies and their specificity in Zhongshan area

林惠燕 1吴泳伦 1孙爱农 1方育如 1陈前英 1李乔 1王玉珏 2王红梅 2杨志钊 3简晓毅 4许先国 5段生宝2
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作者信息

  • 1. 中山市中心血站,广东中山 528400
  • 2. 中国科学院苏州生物医学工程技术研究所
  • 3. 中山市人民医院
  • 4. 中山市博爱医院
  • 5. 浙江省血液中心
  • 折叠

摘要

目的 了解广东中山地区无偿献血者及患者血小板抗体发生频率,研究血小板抗体特异性和交叉配型.方法 利用固相免疫吸附法(SPIA)对献血者及患者血小板抗体进行筛查,流式细胞术(FCM)进行复查,Pak-Plus酶免法进行抗体特异性鉴定,并采用SPIA模拟血小板交叉配型.结果 共检测献血者标本1 049份,患者标本598份,SPIA筛查阳性分别为6(0.57%)份vs 49(8.19%)份(P<0.05);SPIA检测阳性标本中,献血者FCM、酶免法复查阳性符合率100%,患者FCM复查阳性符合率95%,酶免法阳性符合率88%;献血者初筛阳性标本中,5份为抗-HLA Ⅰ占83%,1份为抗-CD36占17%(人群发生率为0.10%).14份酶免阳性患者标本中,2份抗-GP Ⅱb/Ⅲa,1份抗-GP Ⅰa/Ⅱa,8份抗-HLA Ⅰ,3份为混合抗体(HLA Ⅰ和GP Ⅱb/Ⅲa、GP Ⅰa/Ⅱa),按抗体种类计算,HLA Ⅰ抗体最多,占65%(11/17),其次为与HPA相关的抗-GP占 35%(6/17).血小板抗体阳性配型率低于30%的患者占多数,为71.4%(10/14).结论 中山地区患者血小板抗体阳性率明显高于无偿献血者,多为抗-HLAⅠ、抗-GP,抗-CD36发生率极低,因此应建立已知血小板抗原供者库,同时应开展患者血小板抗体检测及其配型,有助于解决临床血小板输注无效的问题.

Abstract

Objective To investigate the frequency of platelet antibodies in voluntary blood donors and patients in Zhongshan,Guangdong Province,and to study the specificity and cross-matching of platelet antibodies.Methods Platelet antibodies of blood donors and patients were screened by solid-phase immunoadsorption(SPIA),rechecked by flow cytometry(FCM),and antibody specificity was identified by PakPlus enzyme immunoassay,and platelet cross-matching was simulated by SPIA.Results A total of 1 049 blood donor samples and 598 patient samples were tested,with 6(0.57%)and 49(8.19%)samples positive for SPIA,respectively(P<0.05);In SPIA positive samples,the positive concordance rate of FCM in blood donors and patients was 100%vs 95%,and that of enzyme immunoassay was 100%vs 88%.Among the initial screening positive samples of blood donors,5 were anti-HLA Ⅰ antibodies,accounting for 83%,and 1 was anti CD36 antibody,accounting for 17%,with an incidence rate of 0.10%.Among the 14 samples of en-zyme immunoassay positive patients,2 were anti-GP Ⅱ b/Ⅲa,1 was anti-GP Ⅱ a/Ⅱ a,8 were anti HLA Ⅰ,and 3 were mixed antibodies(HLA Ⅰ,GP Ⅱ b/Ⅲ a,GP Ⅰ a/Ⅱ a).According to the types of antibodies,HLA Ⅰ antibodies were the most common,accounting for 65%(11/17),followed by HPA related anti GP,accounting for 35%(6/17).The majority of patients had a platelet antibody positive typing rate below 30%,accounting for 71.4%(10/14).Conclusions The pos-itive rate of platelet antibody of patients in Zhongshan area is significantly higher than that of voluntary blood donors,and most of them are anti-HLA Ⅰ and anti-GP,and the incidence of anti-CD36 is extremely low.Therefore,it is neces-sary to establish a known platelet antigen donor bank,and at the same time,carry out platelet antibody testing and match-ing of patients,which is helpful to solve the issue of platelet transfusion refractoriness.

关键词

血小板抗体/血小板输注无效/抗-CD36/无偿献血者/血小板交叉配型(PXM)

Key words

platelet antibodies/platelet transfusion refractoriness/anti-CD36/voluntary blood donors/platelet cross matching(PXM)

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基金项目

中山市社会公益与基础研究项目(2020B1065)

国家卫健委科研项目(WKJ-ZJ-2021)

出版年

2024
中国输血杂志
中国输血协会 中国医学科学院输血研究所

中国输血杂志

CSTPCD
影响因子:1.279
ISSN:1004-549X
参考文献量16
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