【摘要】 目的:依据血小板抗体阳性患者的血小板交叉配型试验及血小板输注的临床治疗效果,以探讨血小板抗体阳性患者血小板输注无效(platelet transfusion refractoriness,PTR)问题更为科学的血小板输注方法。方法:采用固相凝集法进行血小板抗体检测;采用固相凝集法进行血小板交叉配型试验以筛选阴性的供者血小板;依据血小板交叉配型试验的报告,给165名血小板抗体检测阳性患者进行血小板输注;23例血小板抗体检测阳性患者输注随机选取的ABO同型的供者血小板,作为对照组;于输注前及输注后1 h和24 h计数血小板,计算血小板计数增加校正指数(CCI),判定输注效果。结果:165名血小板抗体阳性患者进行血小板交叉配型试验541人次,阳性率为58.41%(316/541),阴性为41.59%(225/541);输注血小板交叉配型试验阴性的供者血小板的有效率为83.56%(122/146),输注阳性的供者血小板的有效率10.53%(2/19),对照组的有效率为30.43%(7/23);比较输注血小板交叉配型试验阴性的供者血小板的有效率和输注血小板交叉配型试验阳性的供者血小板有效率,对照组的有效率,差异有高度显著性(P<0.05)。结论:血小板抗体阳性患者的血小板交叉配型试验有较高的阳性率,应尽可能采用血小板交叉配型试验筛选阴性的供者血小板以提高血小板的输注效果,对血小板抗体阳性患者的血小板输注应进行输注后效果的评估。血小板交叉配型试验和输注后效果的评估是临床解决血小板抗体阳性患者PTR问题的有效途径。更多还原

【Abstract】 Objective:To develop the more scientific platelet transfusion method in the platelet antibody positive patients,who had the platelet transfusion refractoriness(PTR) problem.The platelet cross-match test in the platelet antibody positive patients and the clinical effects of platelet transfusion were observed.Methods: Solid phase aggregation method was used to test the platelet antibody and carried out the platelet cross-match test,which could screen out the donor of negative platelet.Based on the report of the cross-match test,165 platelet antibody positive patients were conducted platelet transfusion.23 cases were selected for random infusion of ABO type platelet from the donor,as control group;Before and after infusion at 1 h and 24 h,platelets were counted and calculated for the platelet count increase correction index(CCI),and then the infusion effect was judged.Results: 165 patients with platelet antibody positive were carried out platelet cross-match test 541 times.The positive rate was 58.41%(316/541),while the negative rate was 41.59%(225/541).The transfusion effective rate of platelet from negative donors in cross-match test was 83.56%(122/146),but that of positive donors was 10.53%(2/19) and the effective rate of the control group was 30.43%(7/23).There were highly significant differences among the groups(P<0.05).Conclusion: Patients with platelet antibody positive had high positive rate in cross-match test,so negative donors should be chosen to supply platelet for platelet antibody positive patients to improve the effect of platelet transfusion.The platelet transfusion effect on platelet antibody positive patients should be assessed.Platelet cross-match test and evaluation of clinical effect after infusion were considered as the effective way to solve PTR problem in platelet antibody positive patients.更多还原