Analysis of influence of pathological factors on positive platelet antibody screening
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摘要: 目的 探究临床不同科室病理因素导致血小板抗体筛查阳性的影响。方法 选择2019至2020年临床申请输注血小板的2364例患者，应用固相凝集法进行血小板抗体筛查，针对患者血小板抗体阳性率、输血史、妊娠史、ABO血型和疾病分布情况统计分析。结果 临床各科室间血小板抗体阳性率不同，产科、血液科、内科和儿科血小板抗体阳性率显著高于其他科室(P< 0.01)；有输血史、妊娠史患者的血小板抗体筛查阳性率明显高于无输血史和妊娠史的患者，差异均有统计学意义(P< 0.01)；ABO血型对科室患者血小板抗体阳性率无影响(P>0.05)；前置胎盘、肿瘤、白血病和早产儿分别是产科、内科、血液科和儿科产生血小板抗体的主要影响因素。结论 不同科室、不同疾病类型的病理因素对血小板抗体阳性有一定的影响。Abstract: Objective To explore the influence of pathological factors on positive platelet antibody screening in different clinical departments.Methods A total of 2364 patients who applied for platelet transfusion in our hospital from 2019 to 2020 and underwent platelet antibody screening by solid phase agglutination were selected.The platelet positive rate, blood transfusion history, pregnancy history, ABO blood group and disease distribution of patients in clinical departments were analyzed.Results The positive rate of platelet antibody was different among clinical departments. The positive rate of platelet antibody in obstetrics, hematology, internal medicine and pediatrics was significantly higher than that in other clinical departments(P< 0.01). The positive rate of platelet antibody screening in patients with history of blood transfusion and pregnancy was significantly higher than that in patients without history of blood transfusion and pregnancy, the differences were statistically significant(P< 0.01). ABO blood group had no effect on the positive rate of platelet antibody in clinical department(P>0.05). Placenta previa, tumor, leukemia and premature birth were the main factors affecting platelet antibody production in obstetrics, medicine, hematology and pediatrics department, respectively.Conclusion The pathological factors of different departments and disease types may have certain influence on platelet antibody positivity.
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Key words:
- clinical department /
- platelet antibody screening /
- pathological factors
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表 1 不同科室血小板阳性率比较
科室 检测例数 阳性例数 阳性率/% 心外科 172 3 1.74 妇科 217 2 0.92 产科 431 77 17.87 内科 278 120 43.17 血液科 278 137 49.28 儿科(新生儿) 268 81 30.22 放疗科 119 3 2.52 普外科 305 6 1.97 骨科 129 2 1.55 神经外科 98 2 2.04 其他科室 69 1 1.45 合计 2364 434 18.36 
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表 2 输血史、妊娠史对血小板抗体检测结果的影响
影响因素 检测例数 阳性例数 阳性率/% 输血史 有 778 205 26.35 无 1586 229 14.44 妊娠史 有 696 188 27.01 无 1668 246 14.75
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表 3 不同血型对血小板抗体检测结果的影响
血型 检测例数 阳性例数 阳性率/% A 695 131 18.85 B 811 147 18.13 O 668 122 18.26 AB 190 34 17.89
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表 4 疾病对血小板抗体检测影响因素的logistic回归分析
科室 影响因素 回归系数 标准误 Wald P OR 95% CI 产科 流产 0.095 0.218 0.190 0.663 1.100 0.717~1.668 前置胎盘 0.941 0.295 10.190 0.001 2.563 1.438~4.566 血小板减少症 -3.143 0.295 113.616 ＜0.001 0.043 0.024~0.077 内科 免疫性疾病 -3.629 0.585 38.482 ＜0.001 0.027 0.008~0.084 消化道出血 0.375 0.226 2.746 0.098 1.455 0.934~2.286 肿瘤 1.749 0.313 31.277 ＜0.001 5.750 3.115~10.614 血液科 血小板减少症 -1.204 0.233 26.761 ＜0.001 0.300 0.190~0.473 白血病 1.099 0.195 31.682 ＜0.001 3.000 2.046~4.398 其他肿瘤 -1.179 0.404 8.499 0.004 0.308 0.139~0.680 儿科 血小板减少症 -1.702 0.188 32.529 ＜0.001 0.342 0.237~0.495 早产儿 -0.566 0.193 8.595 0.003 0.568 0.389~0.829 肿瘤 -0.693 1.225 0.320 0.571 0.500 0.045~5.514 免疫性疾病包括：系统性红斑狼疮、结缔组织病和硬皮病。
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