目的:通过对反复输血(≥3次)患者进行血小板抗体检测,比较阳性与阴性患者血小板输注前后的校正血小板计数增加值(CCI)与血小板输注无效(PTR)发生率,并对阳性PTR患者进行特异性分析,探讨血小板抗体阳性患者的不同抗体阳性率,分析其影响因素,指导后续输注工作。方法:选取2015-06-2016-07收治的反复输血(≥3次)患者156例,均采用微柱凝胶法进行血小板抗体检测,并按照检测结果分为阳性与阴性2组,对2组血小板输注前后的计数进行比较。对阳性患者进行特异性分析,统计其各抗体比例,并分析输血次数与PTR的关系。结果:(1)156例反复输血患者中,54例血小板抗体检查为阳性(34.6%),其中阳性患者PTR为44例(81.5%),1h、24h平均CCI为(6.63±1.16)×109/L和(3.01±1.52)×109/L;阴性患者中PTR为11例(10.8%),1h、24h平均CCI为(15.37±3.22)×109/L和(7.98±3.62)×109/L。(2)对44例血小板抗体阳性的PTR患者进行特异性分析,其中人类白细胞抗原(HLA)抗体33例(75.0%),血小板特异性抗原(HPA)抗体2例(4.5%),同时具有HLA与HPA抗体的患者有3例(6.8%)。(3)3~5次输血患者PTR占23.8%;5~10次输血患者PTR占39.3%;10次以上输血患者PTR占39.6%。血小板抗体阳性率及PTR例数等与输血次数呈正相关。结论:反复输血(≥3次)患者中血小板抗体阳性患者引起PTR的比率要远高于阴性患者(P<0.05),而且PTR的发生跟患者以往输血次数呈正相关,因此对反复输血患者再次输注前进行血小板抗体检测是必要的,对于后续配型输注及节约输注成本具有重要的指导意义。 OBJECTIVE: To compare platelet counts (CCI) and platelet transfusion ineffectiveness (PTR) before and after platelet transfusion in patients with recurrent blood transfusion (≥3 times), and to compare the positive rate of positive PTR The patients were analyzed specifically to explore the positive rate of different antibodies in patients with positive platelet antibodies, analyze the influencing factors and guide the follow-up infusion. Methods: A total of 156 patients with repeated blood transfusion (≥3 times) were enrolled in this study from June 2015 to June 2016. All patients were tested for platelet antibody by microcolumn gel method and divided into 2 groups according to the test results. Before and after platelet transfusion, the counts were compared. Specificity analysis of positive patients, statistics of the proportion of each antibody, and analysis of the relationship between the number of transfusions and PTR. Results: (1) Of the 156 patients with repeated transfusion, 54 were positive for platelet antibodies (34.6%), of which 44 (81.5%) had positive PTR, and the average CCI was (6.63 ± 1.16) × 109 / L and (3.01 ± 1.52) × 109 / L, respectively. PTR in negative patients was 11 (10.8%). The average CCI at 1h and 24h was (15.37 ± 3.22) × 109 / L and (7.98 ± 3.62) × 109 / L, respectively. (2) Forty-four patients with platelet-positive PTR were analyzed specifically, of whom 33 (75.0%) had HLA antibodies and 2 (4.5%) had HPA antibodies, and HLA There were 3 patients (6.8%) with HPA antibody. (3) PTR accounted for 23.8% in 3 to 5 transfusions, PTR accounted for 39.3% in 5 to 10 transfusions, and PTR accounted for 39.6% in 10 transfusions. The positive rate of platelet antibody and the number of PTR were positively correlated with the number of transfusions. CONCLUSIONS: The rate of PTR induced by platelet antibody-positive patients in repeated transfusion (≥3 times) patients is much higher than that in negative patients (P <0.05), and the occurrence of PTR is positively correlated with the number of transfusions in patients. Therefore, Note the detection of platelet antibodies is necessary for the follow-up matching infusion and save the cost of infusion has an important guiding significance.