【摘要】 目的 探讨利用血小板供者资料库开展供、患者人类白细胞抗原(HLA)基因匹配的血小板输注在治疗HLA抗原抗体不相和导致的严重血小板输注无效(PTR)中的疗效。方法 通过实时荧光定量PCR的方法获取患者的HLA-Ⅰ类基因型，在血小板供者资料库中检索与患者HLA分型相匹配的献血者，选择配合级别高的血小板推荐输注。结果 19名患者中有7名患者检索到B2U以上的供者，6名患者检索到BX级以上的供者，6名患者没有检索到合适的供者。通过对输注后24 h血小板增加量(CCI)的计算评估输注效果，发现输注均有效。结论 对于严重的PTR患者，在血小板供者资料库中查询HLA基因分型相匹配的供者，通过供患者的基因匹配来选择合适的血小板进行输注来达到良好输血效果是治疗PTR的最有效手段。更多还原

【Abstract】 Objective To investigate the therapeutic efficacy of HLA-genotype matched platelet transfusion using a platelet donor database for severe platelet transfusion refractoriness(PTR) caused by HLA antigen-antibody incompatibility. Methods Using real-time quantitative PCR(qPCR) to identify he patient’s HLA class I genotype, followed by searching the platelet donor database for matching donors, and selecting highly compatible donors for transfusion. Platelets with higher compatibility levels were prioritized for transfusion recommendations. Results Among the 19 patients studied, 7 patients identified donors with B2U or higher compatibility, 6 patients identified donors with BX or higher compatibility, and 6 patients did not find a suitable donor. The transfusion efficacy was evaluated by calculating the corrected count increment(CCI) 24 hours post-transfusion, and all transfusions were effective. Conclusion The optimal strategy to prevent and treat patients with severe platelet transfusion refractoriness is to ensure patients receive platelet transfusions that are matched to their HLA genes, and this approach significantly enhances transfusion efficacy.更多还原