关键词: 血小板抗原, 血小板膜糖蛋白, 整合素α_Ⅱbβ₃, 血小板输注无效, 基因多态性

Abstract:

Objective To investigate the relationship between gene polymorphism and therapeutic effect of platelet transfusion by detecting the gene polymorphism of platelet glycoprotein(GP) Ⅱb/Ⅲa and platelet antibody in 98 patients. Methods A total of 9 sites of 5 exons in GP Ⅱb/Ⅲa gene were amplified by polymerase chain reaction(PCR),and PCR products were directly sequenced to analyze the gene polymorphism. Platelet antibody was detected by solid phase agglutination assay. Results Only T18809G variation existing in Exon 26 of GP Ⅱb gene was found in 98 patients,which causing Ile843Ser polymorphism and producing HPA-3aa/ab/bb genotypes. All of the 3 genotypes can cause platelet antibodies,resulting platelet transfusion refractoriness. The positive rate of platelet antibody in 98 patients was 52.0%, the total effective rate of 1 468 platelet transfusion was 77.8%,and the effective rate of 65 matched platelet transfusion was 83.1%. There were no significant differences among the 3 genotypes. Conclusions The specificity and associated platelet antibody are the main immune factors for causing platelet transfusion refractoriness, and HPA-3 polymorphism in GP Ⅱb gene is associated with platelet transfusion refractoriness.

Key words: Platelet antigen, Platelet glycoprotein, Integrin α_Ⅱbβ₃, Platelet transfusion refractoriness, Gene polymorphism