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目的:回顾性分析Rh阴性患者输注ABO同型Rh阳性单采血小板的临床治疗效果。方法:在没有预防性输注Rh免疫球蛋白的情况下,给予33例Rh阴性患者输注Rh阳性血小板,检测输注前后各24h的外周血血小板计数,并计算出血小板增加值,与对照组35例阳性患者输注阳性血小板的效果进行比较,来评估血小板输注的疗效。并在随访中,用间接抗人球蛋白卡法检测患者输注血小板后的抗D抗体水平。结果:Rh阴性患者输注Rh阳性血小板24h后血小板增加值为(12.45±9.96)×109/L,阳性患者输注阳性血小板24h后血小板增加值为(8.12±7.63)×109/L,3组数据差异无统计学意义(P>0.05),即Rh阴性患者输注Rh阳性血小板与RhD同型输注血小板治疗效果差异无统计学意义,患者症状明显改善。20例患者输注血小板(66.2±30.0)d后抗D抗体均为阴性。结论:Rh阴性患者输注Rh阳性单采血小板的疗效显著,RhD抗原引起同种免疫的频率极低,可以给予Rh阴性患者输注Rh阳性单采血小板。
Objective: To retrospectively analyze the clinical effect of Rh-positive patients receiving ABO-positive Rh-platelets. Methods: Rh-positive platelets were infused into 33 Rh-negative patients without preventive infusion of Rh immunoglobulin. Peripheral blood platelet counts were measured before and after transfusion for 24 h. The added value of platelet was calculated. Compared with the control group 35 cases of positive patients transfusion of positive platelets were compared to assess the efficacy of platelet transfusion. At follow-up, the level of anti-D antibody after platelet transfusion was measured by indirect anti-human globulin card assay. Results: The value of thrombocytopenia was (12.45 ± 9.96) × 109 / L after rh-positive platelet transfusion in Rh-negative patients and (8.12 ± 7.63) × 109 / L after positive platelet transfusion for 24h There was no significant difference between the two groups (P> 0.05). Rh-negative patients had no significant difference in Rh-type platelet transfusion with RhD-type platelet transfusion. Symptoms of patients were significantly improved. Anti-D antibodies were negative in 20 patients after transfusion of platelets (66.2 ± 30.0) days. CONCLUSIONS: Rh-negative patients have a significant effect of transfusion of Rh-positive apheresis platelets, and RhD antigen-causing alloimmunization is extremely rare. Rh-positive patients can be given Rh-positive apheresis platelets.