微柱凝胶免疫分析技术在血小板抗体筛选中应用.docVIP

微柱凝胶免疫分析技术在血小板抗体筛选中应用 　作者：许德义 董国飞 张哲 彭明喜 杜勇 陈长水 汤晓娴 付荆艳 高家良 白洁 马幼丽 钱伯勇 马建波 【摘要】 为了探讨微柱凝胶免疫分析技术在血小板输注中血小板抗体筛选和配型的临床应用价值，运用微柱凝胶免疫分析技术检测血小板抗原抗体反应,包括抗体筛检、交叉配血。结果显示： 30例再生障碍性贫血（AA）、11例骨髓增生异常综合征（MDS）和25例白血病患者中24例血小板抗体的检测均为阳性，20例其他病例中有1例血小板抗体检测阳性（占5%），20例正常献血员的血小板抗体检测均为阴性。多次输注血小板的112个AA血液标本、42个MDS血液标本和95个白血病血液标本的血小板抗体交叉相合数分别为45、20和40个，相合率分别为40.18%、47.62%和42.11%； 20例多次输注血小板的病人交叉配合前的血小板增高指数(CCI)平均为4.7，交叉配合后为18.2。结论：恶性血液病患者中血小板抗体筛检的阳性率很高；249个血液标本的血小板交叉配型的相合率在40%-48%之间；交叉配型后的血小板临床使用效果明显提高。 【关键词】 微柱凝胶免疫法 Application of Microcolumn Gel Immunoassay in Screening the Platelet Antibody Abstract The purpose of this study was to explore the clinical value of the platelet antibody screening and typing in platelets transfusion by using microcolumn gel immunoassay (MGIA). The platelets antigenantibody reactions including the antibody screen and blood crossmatch were detected by MGIA. The results indicated that the detection of platelet antibody showed positive in 30 cases of aplastic anemia (AA), 11 cases of myelodysplastic syndrome (MDS), 24 out of 25 cases of leukemia and 1 out of cases of other diseases, while detection of platelet antibody showed negative in 20 normal volunteer donors. The number of platelet antibody crossmatch coincidence in 112 specimens of AA, 42 specimens of MDS and 95 specimens of leukemia were 45, 20 and 40, the coincidence rates were 40.18%、47.62% and 42.11% .The mean corrected count increment (CCI) in 20 patients received platelet transfusion many times was 18.2 after crossmatch and 4.7 before crossmatch. It is concluded that the positive rate of platelet antibody screening is very high in patients with hematologic malignancies, the coincidence rate of platelet antibody crossmatch in 249 blood samples is between 40% and 48%, and the effeciency of using crossmatched platelets in clinic is enhanced significantly. Key words platelet antibody screening; platelet typing; microcolumn gel immunoassay 近年来，随着临床输血事业的发展、成分输血的推广，各种血液成分的应用也正在发生变化, 血小板（Plt）的使用日益广泛。然而