摘要
目的探讨高原不同血红蛋白(Hb)水平人群血液制备的悬浮红细胞储存质量的差异。方法选择久居高原地区不同Hb水平的男性志愿者分为2个实验组,A组:10名,Hb≥180 g/L;B组:10名,Hb(120—160)g/L;另以平原地区正常男性志愿者为对照组(C组):10名,Hb(120—160)g/L。各组分别采集全血200 mL/人(份)(10份/组),离心分离去除血浆后,加入MAP保存液50 mL/份,制备得到的悬浮红细胞平均分装到4个50 mL小袋,于4℃冰箱储存d1、d7、d21、d35分别按不同检测项目取同等量标本测定反映红细胞质量的制备。结果 A、B、C 3组悬浮红细胞储存d1、d7、d21、d35溶血率(%)分别为:0.05±0.03 vs 0.06±0.07 vs 0.05±0.01,0.05±0.03 vs 0.05±0.04 vs0.05±0.03,0.06±0.03 vs 0.07±0.04 vs 0.06±0.03,0.10±0.05 vs 0.09±0.04 vs 0.07±0.03(P>0.05);红细胞渗透脆性(g/L)分别为:4.22±0.19 vs 4.18±0.15 vs 4.18±0.14,4.06±0.28 vs4.16±0.10 vs 4.25±0.15,4.09±0.26 vs 4.14±0.15 vs 4.17±0.12,4.11±0.25 vs4.12±0.14 vs 4.11±0.12(P>0.05);红细胞变形指数(200-1)分别为:0.58±0.03 vs0.58±0.02 vs 0.58±0.01,0.58±0.03 vs 0.57±0.02 vs 0.59±0.02,0.55±0.04 vs 0.55±0.03 vs 0.57±0.02,0.54±0.05vs 0.53±0.03 vs 0.55±0.02(P>0.05)。结论采用高原不同Hb水平人群血液制备的悬浮红细胞在正常储存时间内的质量均符合现行血液储存的质量标准。
Objective To explore the difference of stored suspended red blood cells(RBCs) prepared from Tibetan plateau males with different hemoglobin levels. Methods Healthy Tibetan male volunteers were divided into 2 groups based on hemoglobin levels: group A(Hb≥180 g/L) and B(160 g/L≥Hb≥120 g/L). Healthy male volunteers from plain areas functioned as the control: group C(160 g/L≥Hb≥120 g/L). 200 mL whole blood samples were collected all volunteers of the 3 groups(each group n = 10) and was centrifuged to remove plasma. The packed RBCs were re-suspended in 50 ml of MAP and then divided into 4 separate bags(50 ml each) for storage at 4 C°.RBCs were sampled on d1,d7,d21 and d35 to evaluate storage quality with couple of selected indexes. Results NO statistically significant difference(P>0. 05) was found in the amount of Hemolytic rate and osmotic fragility. Deformability were found on d1,d7,d21,d35 in all 3 groups. The results of the Hemolytic rates were(order: A,B,C):(0. 05± 0. 03 vs 0. 06± 0. 07 vs 0. 05± 0. 01) %,(0. 05± 0. 03 vs 0. 05±0. 04 vs 0. 05±0. 03) %,(0. 06±0. 03 vs 0. 07±0. 04 vs 0. 06±0. 03) %,(0. 10±0. 05 vs 0. 09± 0. 04 vs 0. 07± 0. 03) %. The results of osmotic fragility were(0. 05 ± 0. 03 vs 0. 06 ± 0. 07 vs 0. 05 ± 0. 01) %,(0. 05 ± 0. 03 vs 0. 05 ± 0. 04 vs 0. 05 ±0. 03) %,(0. 06±0. 03 vs 0. 07±0. 04 vs 0. 06±0. 03) %,(0. 10±0. 05 vs 0. 09±0. 04 vs 0. 07±0. 03) % respectively. The results of the deformability of RBCs were(0. 05±0. 03 vs 0. 06±0. 07 vs 0. 05±0. 01) %,(0. 05±0. 03 vs 0. 05±0. 04 vs 0. 05±0. 03) %,(0. 06±0. 03 vs 0. 07±0. 04 vs 0. 06± 0. 03) %,(0. 10± 0. 05 vs 0. 09± 0. 04 vs 0. 07± 0. 03) % respectively. Conclusion There are no significant differences in several indicators of RBC storage quality. All 3 groups meets the current quality requirement of blood storage.
引文
[1]GB184692—2012.全血及成分血质量要求.北京:中国标准出版社,2012.6.
[2]吴小东,杜磊,高原红细胞增多症.中国输血杂志,2013,26(6):589-592.
[3]YY0329-2009.一次性使用去白细胞滤器.
[4]Margaret F.Gerry Healey V,Rosemary L.Sparrow.Effect of additive solutions on red blood cell(RBC)membrane properties of stored RBCs prepared from whole blood held for 24 hours at room temperature.Transfusion.2011,51(S1):25S-33S.
[5]Hess JR.An update on solutions for red cell storage.Vox Sang,2006,91(1):13-19.
[6]张瑞君,鞠春梅,闫景刚,等,不同储存期去白细胞悬浮红细胞携氧指标的变化,实用医学杂志,实用医学杂志,2014,21(30):3508-3510
[7]王向明,王珏,甘佳,等.储存红细胞生化指标研究进展.中国输血杂志,2016.10(10):1205-1209.
[8]Nogueira D,Rocha S,Abreu E,et al.Biochemical and cellular changes in leukocyte-Depleted red blood cells stored for transfusion.Transfus Med Hemother,2014,42(1):46-51.
[9]王红,贺曾,吴瑕,等.滤除白细胞对全血保存质量的影响.中国输血杂志,2013,26(6):525-529.
[10]赵莉,赵燕.保存前滤除白细胞对红细胞保存质量的研究分析.齐齐哈尔医学院报,2011,32(7):1029-1031
[11]李遥金,王翔,兰珂.血液保存对红细胞携氧功能及能量代谢的影响.中国输血杂志,2009,22(6):439-443
[12]Beutler E,West C.The storage of hard-packed red blood cells in citrate-phosphate-dextrose(CPD)and CPD-adenine(CPDA-1).Blood,1979,54(1):280-284.
[13]钟锐,王红,扎西顿珠,等.高原地区悬浮红细胞保存质量研究.中国输血杂志,2014.7(7):702-705.
[14]于增国.血液与血液疾病细胞形态学图谱.版次?,北京:人民军医出版社,2012:35-36.
[15]Dzik WH.The air we breathe:three vital respiratory gases and the red blood cell:oxygen,nitric oxide,and carbon dioxide.Transfusion,2011,51(4):676-685.
[16]叶应妩,王毓三,申子瑜.全国临床检验操作规程.3版.东南大学出版社,2006:168-169.
[17]杨谦,孙润广.红细胞膜弹性特性的AFM力曲线测量.中国科学C辑:生命科学,2008,38(11):1013-1027.
[18]温洁新,杨雪梅,闫国超,等.储存时间内红细胞免疫功能的变化.山西医药杂志,2014.43(8):951-952.
[19]Whillier S,Raftos JE,Sparrow RL,et al.The effects of long-term storage of human red blood cells on the glutathione synthesis rate and steady-state concentration.Transfusion,2011,51(7):1450-1459.
[20]徐光辉.红细胞变形性聚集性检测及临床分析.中国血液流变学杂志.1998,8(l):70-72.