中国输血杂志2023，Vol.36Issue(12)：1127-1131,5.DOI:10.13303/j.cjbt.issn.1004-549x.2023.12.011
肿瘤患者血小板输注疗效影响因素及HLA-Ⅰ类抗体特异性分析
Factors affecting the efficacy of platelet transfusion and specificity of HLA-Ⅰantibodies in tumor patients
摘要
Abstract
Objective To analyze the factors affecting the efficacy of platelet transfusion and the specificity of HLA-Ⅰanti-bodies in tumor patients.Methods Tumer patients applied for platelet transfusion from November 2019 to July 2021 in Si-chuan Cancer Hospital province were screened for platelet antibodies.The transfusion efficacy was evaluated and its influencing factors were analyzed,Antibody positive patients were detected for HLA-Ⅰantibodies.Results The positive rates of platelet antibody and HLA-Ⅰantibody,as well as the platelet transfusion refractoriness rate were 35.2%(50/142),32.4%(46/142)and 16.9%(24/142),respectively.The platelet refractoriness rate of platelet antibody positive patients was higher than that of platelet antibody negative patients[30.0%(15/50)vs 9.8%(9/92)](χ2=9.428,P＜0.05).Multivariate logistic results showed that gender(χ2=12.608,P＜0.001,OR=3.800,95%CI:1.819-7.940)was an independent risk factor for platelet antibody pro-duction,and platelet antibody(χ2=8.648,P＜0.05,OR=3.952,95%CI:1.581～9.878)was the independent risk factor for transfusion efficacy.The detection rates of strong positive,positive and weak positive HLA-I antibodies were 69.6%(32/46),80.4%(37/46)and 97.8%(45/46),respectively.The antibodies with high detection rate were anti-B∗15∶12,anti-B∗57∶03,anti-B∗57∶01,anti-B∗13∶02,anti-B∗49∶01,anti-B∗50∶01,anti-A∗25∶01,anti-B∗15∶01,anti-B∗15∶02 and anti-B∗44∶02.There were 19 kinds of HLA-Ⅰantibodies with MFI≥10 000,including anti-A∗02∶01,anti-A∗02∶03 and anti-A∗02∶06.The CCI values were lower in HLA-Ⅰantibody positive patients(n=46)than in HLA-I antibody negative patients(n=96)by Wilcoxon test(P＜0.05).Conclusion Among tumor patients who received platelet transfusion,gender(female)was the risk factor for platelet antibody production.Platelet antibody positive patients were prone to platelet transfusion refractoriness.HLA-Ⅰantibodies were the main platelet antibodies,suggesting that HLA-Ⅰgene matching platelets could improve the efficacy of platelet transfusion.关键词
血小板输注/血小板抗体/输注疗效/HLA-Ⅰ类抗体/抗体特异性Key words
platelet transfusion/platelet antibody/transfusion efficacy/HLA-Ⅰantibodies/antibody specificity分类
医药卫生引用本文复制引用
赛娟,万珊珊,田力..肿瘤患者血小板输注疗效影响因素及HLA-Ⅰ类抗体特异性分析[J].中国输血杂志,2023,36(12):1127-1131,5.基金项目
中国医学科学院医学与健康科技创新工程(021-1-I2M-060) （021-1-I2M-060）
