作者：Janice G.. McFarland

来源：Transfusion and Apheresis Science. 2003. 28:297-305

摘要：检测和鉴定与血小板反应抗体的血清学方法从基于血小板功能位点的低敏感低特异的第I代方法到检测对象为血小板相关免疫球蛋白的较敏感的第II代方法，再到更为敏感的第III代方法即检测与位于血小板表面糖蛋白的同种抗原结合的抗体。第II代和第III代方法用于检测怀疑有血小板同种免疫症状的新生儿同种免疫性血小板减少症(NATP)、输血后紫癜(PTP)以及血小板交叉配合试验。流式细胞术属于第II代检测方法，改良后可检测药物依赖性抗体。当前，利用第I代检测方法C14-复合胺释放试验和第三代方法的血小板第四因子ELISA试验，现用于诊断肝素诱导的血小板减少症(HIT)。检测特发性血小板减少性紫癜（ITP）的足够敏感和特异的方法依然不明朗。

Detection and identification of platelet antibodies in clinical disorders

Janice G.McFarland

Transfusion and Apheresis Science. 2003. 28:297-305

Abstract: Serologic assays to detect and identify platelet-reactive antibodies have progressed from less sensitive and specific Phase I tests based on platelet functional endpoints through more sensitive Phase II assays that detect platelet-associated immunoglobulins, to highly specific Phase III assays that detect antibodies bound to alloantigens located on isolated platelet surface glycoproteins. Phase II and III assays are useful in the evaluation of patients with suspected platelet alloimmune syndromes neonatal alloimmune thrombocytopenia (NATP) and post-transfusion purpura (PTP) as well as in platelet crossmatching. Flow cytometry, a Phase II assay, can be modified to detect drug-dependent platelet-reactive antibodies. 14C-serotonin release, a Phase I assay and the platelet factor 4 ELISA, a Phase III assay, are now used to diagnose patients with heparin-induced thrombocytopenia (HIT). A sufficiently sensitive and specific assay to diagnose idiopathic (autoimmune) thrombocytopenia (ITP) remains elusive.

本栏目负责人：杨亚丽