作　　者： (李玉梅）; (徐恒仕）; (王志良）;

机构地区： 上海交通大学医学院附属第九人民医院输血科,上海201900

出　　处： 《中国输血杂志》 2017年第7期744-747,共4页

摘　　要： 目的探讨HPA基因多态性及其等位基因对血小板输注效果的影响。方法自2015年1月-2017年1月,连续性收集50例本院收治的血小板输注无效患者作为观察组,同期收集50例血小板输注有效的患者作为对照组,观察2组患者HPA基因多态性。结果与对照组比较,观察组患者供患双方HPA分型相合率显著降低(4.00%vs 82.00%,P<0.05);血小板恢复百分比显著降低[(11.91±3.23)%vs(31.56±7.38)%,P<0.05);血小板纠正增加指数显著降低(6.84±2.27 vs 16.38±1.92,P<0.05)。2组患者HPA等位基因(HPA1-6,9,15)均以纯合子aa为多见。但观察组HPA-2等位基因为aa、ab、bb的分别有37、8、5例,对照组分别有48、2、0例,差异有统计学意义(P<0.05);观察组HPA-3等位基因为aa、ab、bb的分别有33、9、8例,对照组分别有46、3、1例,差异有统计学差异(P<0.05)。观察组HPA-15等位基因为aa、ab、bb的分别有35、8、7例,对照组分别有47、2、1例,差异有统计学意义(P<0.05)。2组患者的血小板供者HPA等位基因(HPA1-6,9,15)均以纯合子aa为多见,差异均无统计学意义(P>0.05)。血小板输注无效患者HPA-2,3等位基因为aa、ab和bb的血小板恢复百分比、血小板纠正增加指数逐步下降(P<0.05)。结论血小板输注无效与HPA基因多态性有关,等位基因型b可能是导致血小板输注无效的原因。 Objective To investigate the effect of HPA gene polymorphism and its alleles on platelet transfusion. Meth-ocls From January 2015 to January 2017, 50 patients suffered from Platelet transfusion refractoriness were collected as an observation group while 50 patients without Platelet transfusion refractoriness were collected as a control group. The HPA gene polymorphism of the both groups were compared. Results When compared with the control group, the HPA type coincidence rate of Donor and recipient in the observation group decreased significantly （4. 00% vs. 82. 00%, P= 0. 000）. And patients in the observation group got decreased levels of percent platelet recovery and platelet corrected growth index. （ HPA1- 6,9,15） were common in both groups. However, aa, ab and bb of the HPA-2 allele got 37, 8 and 5 cases in the observation group, while there were 48, 2 and 0 eases in the control group （P= 0. 007）. And aa, ab and bb of the HPA-3 allele got 33, 9 and 8 cases in the observation group, while there were 46, 3 and 1 cases in the control group （P = 0. 005）. Moreover, aa, ab and bb of the HPA-15 allele got 35, 8 and 7 cases in the observation group, while there were 47, 2 and 1 eases in the control group （P = 0. 007）. Homozygous aa were the most common gene type in the donors of the both groups, and the difference was no statistically significant （P〉0. 05）. As aa, ab and bb of the HPA-2,3 change, the percent platelet recovery and platelet corrected growth index both decreased （P〈0. 05）. Conehmion Platelet transfusion refractoriness is related to HPA gene polymorphism, and allele b may be the cause of platelet transfusion refractoriness.

关 键 词： 基因多态性 血小板 等位基因