对新鲜冰冻血浆输注前滤除白细胞必要性的评估  

Necessity of routine leukocyte filtration for fresh frozen plasma before transfusion

作　　者：韩玮[1,2] 陶涛[3] 陈民才[1] 王全立[1] 

机构地区：[1]军事医学科学院附属医院输血科,北京100071 [2]北京市公安局丰台分局物证鉴定所,北京100072 [3]第二炮兵防护防疫环境监测队,北京100071

出　　处：《第三军医大学学报》2008年第24期2332-2334,共3页Journal of Third Military Medical University

摘　　要：目的评估新鲜冰冻血浆(fresh frozen plasma,FFP)输注前常规过滤白细胞的必要性,为合理使用FFP提供实验依据。方法通过调整血浆分离时间和剩余血浆量,试验9种血浆制备条件,观察不同的制备条件对白细胞残留量的影响;调查4个采供血机构FFP白细胞残留量;使用5种国产血浆滤器对FFP进行过滤,观察白细胞去除效果和对血浆质量的影响。结果延长血浆分离时间和增加血浆残留量可有效地降低血浆白细胞残留量,达到<1×106/U的水平;4个采供血机构FFP白细胞残留量大多<1×106/U;国产血浆滤器对血浆质量无显著影响,但去白细胞效率低于国外同类产品水平、血浆损失率较高。结论在规范血浆制备规程的前提下,FFP输注前不必进行常规白细胞过滤,血浆置换等特殊情况可考虑白细胞过滤。Objective To evaluate if routine leukocyte filtration for fresh frozen plasma （FFP） is necessary, so as to provide experimental base for appropriate uses of FFP. Methods Nine plasma preparation conditions were tested, in which plasma separation time and plasma residual were adjusted. A preparation method that could effectively decrease the leukocyte residual in plasma was found. Leukocyte residual in FFP from four blood centers was investigated. Five home-made plasma filters were used for FFP filtration and their effectiveness on leukocyte reduction in plasma was observed. Results Prolonged plasma separation time and increased plasma residual could decrease the leukocyte residual effectively and make it reach the leukocyte reduction standard （ 〈 1×10^6/U）. Leukocyte residual in most FFP from 4 blood centers was less than 1×10^6/U. The home-made plasma filters did not have any adverse impact on the quality of plasma, but their leukocyte reduction effectiveness was limited with a high plasma loss rate. Conclusion Compliance to standard plasma preparation procedures makes unnecessary routine leukocyte filtration for FFP. Plasma filtration could be used in some special clinical therapy, such as plasma replacement. The filtration effect of some home-made plasma filters needs to be improved.

关 键 词：新鲜冰冻血浆 白细胞过滤 残留白细胞 血浆滤器 

分 类 号：R331.142[医药卫生—人体生理学] R457.14[医药卫生—基础医学]