Correlation between expression of HLA-Ⅰantibody and platelet membrane glycoprotein CD41a and platelet transfusion refractoriness and influencing factors of PTR
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摘要: 目的:分析HLA-Ⅰ抗体及血小板膜糖蛋白CD41a的表达与血小板输注无效(PTR)相关性及影响因素。方法:将2019年7月—2020年10月收治的50例PTR患者作为观察组,50例行血小板输注治疗有效患者作为对照组;采集患者临床资料,检测患者血小板HLA-Ⅰ抗体和CD41a表达水平。绘制受试者工作特征(ROC)曲线,分析HLA-Ⅰ抗体及CD41a单独和联合应用预测PTR的发生价值,采用Logistic回归模型分析PTR的影响因素。结果:观察组患者血中HLA-Ⅰ抗体和CD41a阳性率均明显高于对照组(P<0.05);联合检测患者血中HLA-Ⅰ抗体和CD41a预测患者PTR的敏感度、特异度及ROC曲线下面积均明显高于各指标单独应用(P<0.05);HLA-Ⅰ抗体、CD41a、自身抗体、其他抗体、脾肿大、高热及出血是影响PTR发生的独立性影响因素(P<0.05)。结论:HLA-Ⅰ抗体及CD41a的表达在PTR患者中呈阳性,且HLA-Ⅰ抗体、CD41a、自身抗体、其他抗体、脾肿大、高热及出血是影响PTR发生的独立性危险因素。
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关键词:
- HLA-Ⅰ抗体 /
- 血小板膜糖蛋白CD41a /
- 血小板输注无效
Abstract: Objective: To analyze the correlation between the expression of HLA-Ⅰ antibody and CD41 a and platelet transfusion refractoriness(PTR) and the influencing factors of PTR.Methods: A total of 50 patients with PTR in our hospital from July 2019 to October 2020 were selected as the observation group, and 50 patients without PTR treated by platelet transfusion were selected as the control group. The clinical data of patients were collected, and the expression levels of HLA-Ⅰ antibody and CD41 a on platelets were detected. ROC curve was drawn to analyze the predictive value of HLA-Ⅰ antibody and CD41 a alone or in combination for PTR. Logistic regression model was used to analyze the influencing factors of PTR.Results: The positive rates of HLA-Ⅰ antibody and CD41 a in the observation group were significantly higher than those in the control group(P<0.05). The sensitivity, specificity and AUC of combined detection of HLA-Ⅰ antibody and CD41 a in the prediction of PTR were significantly higher than those of single application of each index(P<0.05). HLA-Ⅰ antibody, CD41 a, autoantibody, other antibodies, splenomegaly, high fever and bleeding were independent factors affecting PTR(P<0.05).Conclusion: The expression of HLA-I antibody and CD41 a was positive in PTR patients, and HLA-I antibody, CD41 a, autoantibodies, other antibodies, splenomegaly, high fever and hemorrhage might be independent risk factors that affect the occurrence of PTR. -
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