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目的探讨由于父母血小板血型不合产生血小板抗体,诱导新生儿发生同种免疫性血小板减少症的相关性。方法收集22例临床上确诊为新生儿免疫性血小板减少症(NIT)的患儿为研究对象,采用ELISA方法检测患儿及其父母的血小板相关抗体,应用PCR-SSP法对患儿及父母进行HLA及HPA基因分型,根据相应的抗原进行抗体特异性分析。结果 22例NIT患儿中,14例是由于同种免疫性因素引起的,其中27.3%(6例)由HLA抗体引起,13.6%(3例)由HPA抗体引起,22.7%(5例)由HLA+HPA抗体引起;9.1%(2例)由于被动免疫性因素引起;27.3%(6例)由自身抗体引起。其中,同种免疫性抗体以抗HLA-A2、19,抗-B40及抗HPA-3a多见。结论在新生儿免疫性血小板减少症中,主要以父母血小板血型不合引起新生儿同种免疫性血小板减少症为主,临床产前诊断预防和产后治疗具有重要意义。
Objective To investigate the correlation between platelet antibodies induced by non-production of platelet antibodies in parents and induction of alloimmune thrombocytopenia in neonates. Methods Twenty-two children with clinically diagnosed as neonatal thrombocytopenia (NIT) were enrolled in this study. ELISA was used to detect platelet-associated antibodies in children and their parents. PCR-SSP was performed on children and their parents HLA and HPA genotyping, antibody specificity analysis based on the corresponding antigen. Results Of the 22 patients with NIT, 14 were caused by alloimmunity factors, of which 27.3% (6 cases) were caused by HLA antibodies, 13.6% (3 cases) were caused by HPA antibodies and 22.7% (5 cases) were caused by HLA + HPA antibody; 9.1% (2 cases) due to passive immunity; 27.3% (6 cases) caused by autoantibodies. Alloimmunized antibodies were more common than anti-HLA-A2, anti-B40 and anti-HPA-3a. Conclusions In neonatal immune thrombocytopenia, the main cause of neonatal thrombocytopenia is mainly caused by the abnormal blood-type of the platelet in parents and the prevention of prenatal diagnosis and post-natal treatment are of great significance.