血小板输注无效患者体内C1q-HLA抗体的临床意义

doi:10.3969/j.issn.1671-2587.2020.02.004

临床输血与检验 ›› 2020, Vol. 22 ›› Issue (2): 126-130.DOI: 10.3969/j.issn.1671-2587.2020.02.004

血小板输注无效患者体内C1q-HLA抗体的临床意义

李冬妹, 王洁, 敬媛媛, 单小燕, 贾延军

100088 北京市红十字血液中心

收稿日期:2019-07-10 出版日期:2020-04-20 发布日期:2020-04-16
通讯作者: 贾延军,男,主任技师,博士,主要从事血液免疫学相关的研究工作,（E-mail）jiayj321@hotmail.com。
作者简介:李冬妹（1976-）,女,陕西榆林人,主管技师,硕士,主要从事血液免疫学相关研究工作,（Tel）18611425101。

Clinical Significance of C1q-HLA Antibody in Patient Refractory to Platelet Transfusion

LI Dong-mei, WANG Jie, JING Yuan-yuan, et al

Beijing Red Cross Blood Center, Beijing 100088

Received:2019-07-10 Online:2020-04-20 Published:2020-04-16

摘要/Abstract

摘要： 目的通过对血小板输注无效患者体内HLA、HPA抗体的特异性及C1q-HLA抗体的检测,确定C1q-HLA抗体对于血小板输注无效患者的临床意义。方法利用单抗原磁珠（LABScreen® Single Antigen,LSA）和C1q-HLA抗体检测试剂盒对HLA抗体阳性的血小板输注无效患者血清标本进行进一步的检测,确定HLA抗体和HPA抗体的特异性以及这些HLA抗体是否为能结合补体成分C1q的抗体（即C1q-HLA抗体）。结果在40例患者中,10例（25%）患者含有HPA抗体,这些HPA抗体主要是针对糖蛋白GP IIb/IIIa的。39例HLA LSA阳性和28例C1q-HLA抗体阳性患者中,LSA抗体阳性患者的群体反应性抗体百分率（PRA%）和最大平均荧光强度（Max MFI）明显高于C1q-HLA抗体阳性的患者。C1q-HLA抗体阳性和阴性患者之间的CCI值没有显著性差异。不同HLA抗体状态对患者交叉配血寻找相合血小板的难易程度没有显著的影响。结论本研究的结果显示,C1q-HLA抗体是否存在对于血小板输注的疗效并没有直接的相关性,也不会增加患者寻找到相合血小板的难度。

关键词: 血小板输注无效, HLA抗体, HPA抗体, C1q-HLA抗体

Abstract: Objective The specificity of HLA and HPA antibodies as well as C1q-HLA antibodies in patients with platelet transfusion refractoriness （PTR） was analyzed to determine the clinical significance of C1q-HLA antibody for PTR patients. Methods LABScreen® Single Antigen （LSA） kit and C1qScreen™ kit were used to detect the specimens from HLA antibody-positive PTR patient to analyze the specificity of HLA and HPA antibodies, and whether these HLA antibodies could combine with complement component C1q （i.e. C1q-HLA antibodies）. Results In 40 patients, 10 patients （25%） had HPA antibodies which were mainly against glycoprotein GP IIb/IIIa. In 39 cases of HLA-LSA-Positive and 28 C1q-positive patients, the percentage of panel reactive antibody （PRA%） and Max mean fluorescence intensity （MFI） of LSA-positive patients were significantly higher than those of C1q-HLA-positive patients. There was no significant difference in the CCI value between C1q-HLA-positive and -negative patients after random platelet transfusion. Different status of HLA antibodies had no significant effect on finding compatible cross-matched platelets for PTR patients. Conclusion The results of this study showed that there was no direct correlation between C1q-HLA antibodies and clinical result of platelet transfusion. The occurrence of C1q-HLA antibodies may not increase the difficulty of finding compatible cross-matched platelets for PTR patients.

Key words: Platelet transfusion refractoriness, HLA antibodies, HPA antibodies, C1q-HLA antibodies

中图分类号:

R457

李冬妹, 王洁, 敬媛媛, 单小燕, 贾延军. 血小板输注无效患者体内C1q-HLA抗体的临床意义[J]. 临床输血与检验, 2020, 22(2): 126-130.

LI Dong-mei, WANG Jie, JING Yuan-yuan, et al. Clinical Significance of C1q-HLA Antibody in Patient Refractory to Platelet Transfusion[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2020, 22(2): 126-130.

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血小板输注无效患者体内C1q-HLA抗体的临床意义

Clinical Significance of C1q-HLA Antibody in Patient Refractory to Platelet Transfusion

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