Reisner E G, Kostyu D D, Phillips G, Walker C, Dawson D V
Department of Pathology, Duke Medical Center, Durham, North Carolina.
Tissue Antigens. 1987 Oct;30(4):161-6. doi: 10.1111/j.1399-0039.1987.tb01615.x.
Fifty-six adult and 15 pediatric black patients with sickle cell disease were studied to determine their antibody responses to repeated transfusions of red cells. Red cell antibodies were determined retrospectively; anti-lymphocyte antibodies (class I and II) were determined on the single, most recently drawn blood sample. All adults were HLA-A, B, C, DR and DQ typed. Ten percent of the individuals with less than 50 transfusions, but greater than 50% with 100 transfusions or more, had red cell antibodies. The percentage of patients producing anti-red cell antibodies increased consistently with the number of transfusions (p = 0.0062). Women were more likely to become sensitized to red cell antigens than men (p = 0.008), and nulliparous women more likely than multiparous women. Children were also sensitized to red cell antigens (20%), and to a high degree to lymphocyte antigens (73%). No HLA association was found with increased propensity to red cell sensitization. A weak association of HLA DR5 and DR7 with failure to become sensitized to lymphocyte alloantigens was observed, but did not reach statistical significance. Our results suggest that, while genetic factors influencing transfusion response almost certainly exist, other factors such as number of transfusions, age, sex and parity need to be examined to provide accurate projections of risk in chronic transfusion.
对56名成年和15名患镰状细胞病的儿科黑人患者进行了研究，以确定他们对反复输注红细胞的抗体反应。红细胞抗体通过回顾性测定；抗淋巴细胞抗体（I类和II类）在单次最新采集的血样中测定。所有成年患者均进行了HLA-A、B、C、DR和DQ分型。输注次数少于50次的个体中，10%产生了红细胞抗体，但输注100次及以上的个体中，50%以上产生了红细胞抗体。产生抗红细胞抗体的患者百分比随输注次数持续增加（p = 0.0062）。女性比男性更易对红细胞抗原致敏（p = 0.008），未生育女性比经产女性更易致敏。儿童也对红细胞抗原致敏（20%），且对淋巴细胞抗原高度致敏（73%）。未发现HLA与红细胞致敏倾向增加有关。观察到HLA DR5和DR7与未对淋巴细胞同种异体抗原致敏之间存在弱关联，但未达到统计学意义。我们的结果表明，虽然几乎肯定存在影响输血反应的遗传因素，但还需要研究其他因素，如输注次数、年龄、性别和生育史，以便准确预测慢性输血的风险。
