摘要
目的探讨妊娠对女性PLT抗体的影响。方法选择2009年2月至2011年12月在聊城市中心血站血型参比室做产前检查的孕妇291例为研究对象，并纳入研究组，分别在其怀孕第16，20，24，28，30，32，34，36周采集外周血血样；选择同期于本站献血的女性健康献血者4613例纳入对照组，在其献血时采集外周血血样。采用简易致敏红细胞血小板血清学试验法，随机包被5人份O型混合PLT，进行PLT抗体检测。使用烟台海默创新一代血液安全与服务系统进行数据处理。（本研究遵循的程序符合本站人体试验委员会所制定的伦理学标准，得到该伦理会批准，分组征得受试对象本人的知情同意，并与之签订临床研究知情同意书）。结果研究组PLT抗体阳性者为45例，占20．5％（45／219），不同妊娠次数的孕妇间PLT抗体阳性率差异有统计学意义（χ^2=16．409，P〈0．05），PLT抗体阳性率随妊娠次数增加而升高；按妊娠时间比较孕妇PLT抗体阳性率，妊娠第16周至28周，差异有统计学意义（χ^2=16．082，P〈0．05），PLT抗体阳性率随妊娠时间的延长而升高，而第28周至36周，差异无统计学意义（χ^2=0．054，P〉0．05）。对照组PLT抗体阳性者为131例，阴性者为4482例，无妊娠史者与有妊娠史者PLT抗体阳性率之间差异有统计学意义（χ^2=134．676，P〈0．05），有妊娠史者高于无妊娠史者；有妊娠史者按不同妊娠次数比较PLT抗体阳性率，差异有统计学意义（χ^2=235．846，P〈0．05），PLT抗体阳性率随妊娠次数增加而升高；按距离末次妊娠时间比较PLT抗体阳性率，差异有统计学意义（χ^2=48．387，P〈0．05），距离末次妊娠时间越长，PLT抗体阳性率越低。结论妊娠与女性PLT抗体产生密切相关。PLT抗体阳性女性再次妊娠时，在妊娠第16周至第28周监测PLT抗体变化情况，可提前预判同种免疫性血小板减少性紫癜；对妊娠史女性进行PLT抗体检测，可有效预防输血后紫癜、输血后急性肺损伤、PLT输注无效和非溶血性发热反应等输血反应发生。
Objective To explore the influence of pregnancy on women＇s platelet （PLT） antibody. Methods Research objects were divided into the observation group and control group. The members in the observation group were 291 pregnant women who received the prenatal examination in the blood group reference laboratory of Liaocheng Blood Center from February 2009 to December 2011. The members in the control group were 4613 healthy female blood donors donated blood in our station during the same period. Blood samples of observation group were collected when the pregnant women were pregnant in the 16th, 20th, 24th, 28th, 30th, 32nd, 34th and 36th week. Blood samples of control group were collected when they donated blood. Apply simplified sensitized erythrocyte platelet serology assay （SEPSA） method and randomly take 5 samples of mixed platelets of type O blood to test platelet antibody. The Yantai Haimo New Generation of Blood Safety and Service System was adopted for data processing and z inspection was adopted for statistical analysis （The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Liaocheng Blood Center）. Results In the observation group, PLT antibody positive rate was 20.5% （45/219）. PLT antibody positive rate increased with the increase of the number of pregnancy （χ^2= 16. 409,P〈0.05）. During the 16 to 28 weeks of pregnancy, the positive rate increased with the increase of the time of pregnancy （χ^2 =16. 082 ,P〈0.05）. But during the 28 to 36 weeks of pregnancy , the difference of positive rate was not statistically significant （χ^2=0.054,P〉0.05）. In control group, there were 131 positive cases and 4482 negative cases. Positive rate of women who had pregnancy history were higher than who had no pregnancy history （χ^2 = 134. 676, P〈0.05）. For women who had pregnancy history, positive rate increased with the increase of the number of pregnancy （χ^2= 235. 846,P〈0.05）, but the positive rate reduced with the increase of the time to the last pregnancy （χ^2= 48. 387,P〈 0. 05）. Conclusions There was closely relationship between pregnancy and women＇s PLT antibody producing. From the 16th to 28th week of pregnancy, the positive rate of platelet antibody increased with the pregnant time increasing. When a woman with positive platelet antibody was pregnant again, the monitor changes of platelet antibody during the 16th to 28th week pregnancy could prognose the same immune thromboeytopenic purpura. Test the platelet antibody of women who have pregnancy history could effectively prevent the post-transfusion purpura, post-transfusion acute lung injury, platelet transfusion refractoriness, non-hemolytic febrile transfusion reactions and other transfusion reactions.
出处
《国际输血及血液学杂志》
CAS
2012年第5期402-405,共4页
International Journal of Blood Transfusion and Hematology
关键词
血小板
抗体
妊娠
platelet
antibody
pregnancy
