少白细胞混合血小板的制备及临床观察  

Preparation and clinical application of leukocyte-depleted pool platelet concentrates

作　　者：李建斌[1] 张晓莉[1] 单泓[1] 段艳丽[1] 张茵[2] 

机构地区：[1]河南省红十字血液中心,河南郑州450012 [2]河南省人民医院血液科,河南郑州450005

出　　处：《中国医药导报》2007年第09S期30-32,共3页China Medical Herald

摘　　要：目的:探讨少白细胞混合血小板(LDPPCs)的制备方法及临床应用的安全性。方法:利用富血小板血浆法制备出浓缩血小板(PCs)后,将7人份PCs混合,离心洗涤清除袋底的白细胞、红细胞以及血浆,然后加入其中1人份的新鲜血浆200ml悬浮即为LDPPCs。用血小板的MPV、P-LCR、计数、pH和白细胞、红细胞残余量、血小板活化试验、黏附试验等指标来评价血小板洗涤前后的质量变化。随机选择临床内科需要输注血小板的32名患者,分为两组。观察组每次输注1个治疗量(血小板数≥2.5×1011)少白细胞混合血小板,对照组每次输注1个治疗量(血小板数≥2.5×1011)单采血小板,检测输前、输后患者24h血小板计数,并计算血小板校正增加值(CCI)及血小板回收率。结果:洗涤混合前、后及保存72h的MPV、P-LCR、白细胞、红细胞残余量、pH值分别为(8.10±0.12)、(7.20±0.18)、(7.30±0.21)fl,(0.158±0.011)%、(0.146±0.031)%、(0.148±0.024)%,(598.76±803.24)×106、(46.69±60.17)×106、(46.69±60.17)×106,(69.64±49.34)×109、(1.25±1.16)×109、(1.25±1.16)×109,(7.08±0.23)、(6.93±0.39)、(6.93±0.17)。PCs和LDPPCs的PAC-1、黏附率分别为(2.85±0.42)%、(7.65±0.73)%,(4.65±0.34)%、(4.68±0.51)%。LDPPCs、单采血小板临床输注24h后CCI分别为(10.56±5.09)、(12.13±8.82)。洗涤前后P-LCR、pH值相比差异无统计学意义,MPV、白细胞、红细胞残余量相比差异具有统计学意义(P<0.05)。结论:利用此方法制备的LDPPCs的各项质量指标符合国家标准,临床输注是安全的,疗效是确切的,未观察不良反应,可以作为单采血小板的有益补充。Objective： To discuss the method of making leukocyte-depleted pool platelet concentrates （LDPPCs）, and its safety in clinical application. Methods： Platelet concentrate suspend （PCs） were prepared with the rich plasma method. 7 person＇s PCs were pooled, decreased white cells and red cells after eentrifugation, then transferred suspension of LDPPCs to the specific bags of platelet. Washed it with 0.9% salt solution twice, transferred suspension and added 200ml plasma to make LDPPCs. Using MPV,P-LCR, count, pH and hangover of white and red cells, activation test and adhesive test of platelet, to evaluate the quality change of platelet before and after washing. Randomly selected 32 patients needed to be transfused platelet, and to divide into 2 teams （observation and control）.Patients in observation team were transfused 1 cure dosage （platelet count ≥2.5×10^11）of LDPPCs, while those in control were transport 1 cure dosage （platelet count ≥2.5×10^11）of pheresis platelets. Counted the number of platelet before and after 24 h of transfusion and calculated CCI and recovery rates of platelet. Result： MPV, P-LCR, white and red cells, pH of before and after washing,and stored for 72 h were respectively as： （8.10±0.12）,（7.20±0.18）, （7.30±0.21）fl; （0.158±0.011）%, （0.146±0.031）%, （0.148±0.024）%, （598.76±803.24）×10^6, （46.69±60.17）×10^6, （46.69±60.17）×10^6; （69.64±49.34）×10^9, （ 1.25±1.16）×10^9, （ 1.25± 1.16）×10^9; （7.08±0.23）, （6.93±0.39）, （6.93±0.17）o PAC-1 and adhensive rate of PCs and LDPPCs were respectively as： （2.85± 0.42）%, （7.65±0.73）%; （4.65±0.34）%, （4.68±0.51）%. CCI of LDPPCs and pheresis platelets after transfusion 24h were respectively as ：（10.56±5.09）and（12.13±8.82） o P-LCR and pH index before and after washing were not different significantly, while MPV, white and red cells were significantly different （P〈0.05）.Conclusion： The various quality index of LDPP

关 键 词：少白细胞混合血小板 富血小板血浆 白细胞过滤 

分 类 号：R331[医药卫生—人体生理学]