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目的分析影响骨科拟输血患者的血小板特异性抗体(抗-HPA)与组织相容性抗体(抗-HLA-Ⅰ)阳性的相关因素。方法选取1 120名骨科择期手术拟输血患者,分别检测血小板抗体抗-HPA与抗-HLA-Ⅰ,按患者性别、有无输血史、有无妊娠史以及民族、病种等指标分组,评估这些指标对患者血小板抗体阳性的影响。结果本组骨科择期手术拟输血患者血小板抗体总阳性率8.93%(100/1 120),其中抗-HLA-Ⅰ占77%(77/100)、抗-HPA占14%(14/100)、抗-HLA-Ⅰ+抗-HPA占9%(9/100)。本组女性与男性患者的血小板抗体阳性率为13.10(68/519)vs 5.32(32/601)(P<0.01);有无输血史患者的血小板抗体阳性率为15%(15/100)vs 8.33(85/1 020)(P<0.05);有无妊娠史的女性患者血小板抗体阳性率为15.68%(53/338)vs 8.43%(15/178)(P<0.05)。结论骨科拟输血患者中女性患者,尤其是有妊娠史者,以及有输血史患者的血小板抗体阳性率较高,可作为临床开展血小板检测的相关因子,确保安全输血。
Objective To analyze the related factors influencing the positive of platelet-specific antibody (anti-HPA) and histocompatibility antibody (anti-HLA-Ⅰ) in patients with orthopedic transfusion. Methods A total of 1,120 orthopedic patients undergoing elective surgery were enrolled in this study. Anti-HPA and anti-HLA-Ⅰ were detected respectively according to their gender, blood transfusion history, pregnancy history, ethnicity and disease index The impact of the index on the positive of platelet antibodies in patients. Results The total positive rate of platelet antibodies in patients scheduled for orthopedic surgery was 8.93% (100/1 120), including 77% (77/100) for anti-HLA-Ⅰ, 14% (14/100) for anti-HPA, Anti-HLA-Ⅰ + anti-HPA accounted for 9% (9/100). The positive rate of platelet antibody in this group of women and men was 13.10 (68/519) vs 5.32 (32/601) (P <0.01). The positive rate of platelet antibody was 15% (15/100) vs 8.33 (85/1 020) (P <0.05). The positive rate of platelet antibodies in women with or without pregnancy history was 15.68% (53/338) vs 8.43% (15/178) (P <0.05). Conclusion The positive rate of platelet antibodies in female patients, especially those with history of pregnancy, as well as those with history of blood transfusion in orthopedic intertransfusion patients can be used as a relevant factor in the clinical detection of platelet to ensure safe blood transfusion.