【摘要】 目的：检测长春地区血小板输注无效患者体内的HLA和HPA抗体，分析其特异性，确定导致输注无效的主要抗体类型，评估HLA抗原免疫原性，为临床输注策略的制定提供依据。方法：选取2024年1月至12月期间90例血小板输注无效患者的血液样本，采用流式细胞仪-微珠法和ELISA技术检测HLA和HPA抗体，通过统计分析评估抗体分布及其与输注无效的关联性。运用PCR-SSP技术分析患者HPA-1～6、10、15、21系统的基因型。结果：90例患者中40例（44.4%）检出血小板相关抗体。抗体阳性样本中，HLA抗体阳性率为77.5%(31/40),HPA抗体阳性率为35.0%(14/40)，两种抗体共存率为12.5%(5/40)。HLA-A、B、C位点频率最高的等位基因A*02:01、B*13:02和C*06:02，对应的抗体阳性率分别为38.7%、54.8%和22.6%，相对免疫原性分别为0.1101、0.1596和0.3429。低频等位基因A*24:03、B*15:10和C*17:01的相对免疫原性分别高达89.5005、66.5888和29.3497。HPA-3和HPA-15表现出较高的多态性。结论：本研究系统分析了长春地区血小板输注无效患者HLA和HPA抗体特异性分布及HLA抗原免疫原性，发现HLA抗体是导致输注无效的主要因素，且部分低频HLA等位基因呈现较高的免疫原性。更多还原

【Abstract】 Objective:To detect HLA and HPA antibodies in patients with platelet transfusion refractoriness(PTR)in Changchun region,analyze their specificity,identify the major antibodies responsible for transfusion failure,and evaluate the immunogenicity of HLA antigens,so as to provide a basis for the development of clinical transfusion strategies.Methods:Blood samples were collected from 90 patients with PTR from January and December 2024.HLA and HPA antibodies were detected using flow cytometry-microsphere method and ELISA.Statistical analysis was performed to evaluate the distribution of antibodies and their association with transfusion failure.PCR-SSP technology was used to analyze the genotypes of the HPA-1～6,10,15,21 systems.Results:Among the 90 patients,40(44.4%)tested positive for platelet-associated antibodies.In the antibody-positive samples,the positivity rate of HLA antibody was 77.5%(31/40),the positivity rate of HPA antibody was 35.0%(14/40),and the co-existence rate of both antibodies was 12.5%(5/40).The alleles with the highest frequencies at the HLA-A,B,and C loci were A*02:01,B*13:02,and C*06:02,with corresponding antibody positivity rates of 38.7%,54.8%,and 22.6%,and relative immunogenicities of 0.110 1,0.159 6,and 0.342 9,respectively.The relative immunogenicities of the low-frequency alleles A*24:03,B*15:10,and C*17:01 were 89.500 5,66.588 8,and 29.349 7,respectively.The HPA-3 and HPA-15 systems exhibited high polymorphism.Conclusion:This study systematically analyzes the specificity distribution of HLA and HPA antibodies and the immunogenicity of HLA antigens in PTR patients in Changchun region.It finds that HLA antibodies play a dominant role in transfusion failure,and certain low-frequency HLA alleles have higher immunogenicity.更多还原