多次输注血小板的血液病患者产生血小板抗体类型和频率的研究

Study on the Types and Frequency of Platelet Antibodies in Hematologic Patients Receiving Multiple Platelet Transfusions

摘要: 目的：探讨多次接受血小板输注的血液病患者体内血小板抗体的产生类型、频率及其影响因素。方法：选取2022年1月至2025年5月本院收治的423例需反复输注血小板的血液病患者，采用固相凝集法(SPRCA)检测血清中抗人类白细胞抗原(HLA)抗体和抗人类血小板抗原(HPA)抗体。分析抗体阳性率与输注次数、性别等因素的关系。结果：血小板抗体总阳性率为43.9% (186/423)，其中HLA-I类抗体阳性率为23.4% (99/423)，HPA抗体阳性率为6.7% (28/423)，同时检测到HLA-I类抗体和HPA抗体13.9% (59/423)。阳性率随输注次数增加显著升高(P < 0.05)，HLA-I类抗体和HPA抗体的产率生女性患者58.2% (109/187)明显大于男性患者33.1% (78/236)。结论：反复血小板输注是导致患者产生血小板抗体的主要因素，显著影响临床治疗效果。建议对长期多次输注血小板的患者开展血小板抗体筛查，实施个体化配型输注策略。

Abstract: Objective: To investigate the types, frequency, and influencing factors of platelet antibodies in hematologic patients receiving multiple platelet transfusions. Methods: A total of 423 hematologic patients requiring repeated platelet transfusions from January 2022 to May 2025 were enrolled. Solid-phase red cell adherence assay (SPRCA) was used to detect anti-human leukocyte antigen (HLA) antibodies and anti-human platelet antigen (HPA) antibodies in serum. The relationship between antibody positivity rates and factors such as transfusion frequency and gender was analyzed. Results: The overall platelet antibody positivity rate was 43.9% (186/423). Among these, the positivity rate for HLA class I antibodies was 23.4% (99/423), for HPA antibodies 6.7% (28/423), and for both HLA class I and HPA antibodies 13.9% (59/423). The positivity rate increased significantly with the number of transfusions (P < 0.05). The antibody production rate was significantly higher in female patients (58.2%, 109/187) than in male patients (33.1%, 78/236). Conclusion: Repeated platelet transfusions are a major factor leading to the production of platelet antibodies, significantly affecting clinical treatment efficacy. It is recommended that platelet antibody screening and individualized matching transfusion strategies be implemented for patients requiring long-term multiple platelet transfusions.