Screening of anti-platelet antibodies and prospective study of neonatal alloimmune thrombocytopenia

血小板同种抗体在新生儿同种免疫性血小板减少症中起重要作用。HPA（人类血小板抗原）参与新生儿同种免疫性血小板减少症（NAIT）。为了检测血小板抗体，我们建立了检测抗血小板抗体的混合被动血凝（MPHA）法，用MPHA法对20，333份孕妇（孕28-30周）血清进行了筛查，结果如下：(1)198份血清中血小板抗体检出率为0.97%，其特异性依次为：抗HPA-5 b 168份（82.3%），抗HPA-4 b 27份（13.6%），抗HPA-6 b 2份（1.0%），抗Nak-α 5份（2.5%），抗HPA-4 b+抗HPA-5 b 1份（0.5%）。(2)5例NAIT是由于抗HPA-5 b，2例NAIT是由于抗HPA-4 b，1例是由于抗HPA-4 b和抗HPA-5 b。这是第一个关于新生儿同种免疫性血小板血症的前瞻性研究。

Platelet alloantibodies play a important role in neonatal alloimmune thrombocytopeniaHPA (human platelet antigens) are known to be involved in neonatal allo-immunethrombocytopenia (NAIT). For the detection of platelet antibodies, we developed MPHA (mixed passive hemagglutination) method for detecting anti-platelet antibodies.Using MPHA test, we screened 20,333 sera from pregnant women (28-30 weeks gestation) and obtained the following results.(1) Unexpectedly high prevalence of platelet antibodies in 198 sera (0.97%) The specificity of them were as follows,anti-HPA-5b 168 sera(82, 3%), anti-HPA-4b 27 sera(13, 6%)anti-HPA-6b 2 sera(1, 0%), anti-Nak-a 5 sera(2, 5%)anti-HPA-4b+anti-HPA-5b 1 serum(0, 5%).(2) Five cases of NAIT were due to anti-HPA-5b, two cases of NAIT were due to anti-HPA-4b, and one case was due to anti-HPA-4b and anti-HPA-5b. This is the first prospective study on neonatal alloimmune thrombocytemia.