白细胞滤除对机采血小板质量的影响研究  

The Effect of Leukocyte Depletion by Filtration on the Quality of Apheresis Platelets

作　　者：于洋[1] 冯倩[1] 张婷[1] 马春娅[1] 张晓娟[1] 葛国峰[1] 林子林[1] 潘纪春[1] 汪德清[1] 骆群[1] 田亚平[1] 

机构地区：[1]解放军总医院输血科,解放军临床输血中心,北京100853

出　　处：《中国实验血液学杂志》2009年第4期1067-1070,共4页Journal of Experimental Hematology

摘　　要：本研究旨在评价白细胞滤除对机采血小板整体质量的影响。随机选取20单位单供者机采血小板在(22±2)℃条件下振荡保存24-96小时后使用血小板型白细胞过滤器进行过滤,分别检测机采血小板过滤前后的血小板浓度、平均血小板体积(MPV)、血小板单位容量、白细胞量、pH值、乳酸脱氢酶(LDH)浓度、K+浓度、血小板膜表面CD62p表达率、血小板凝血指数MA值,并计算白细胞去除率和血小板损失率。结果表明:机采血小板经白细胞过滤器过滤后,残留白细胞计数明显低于滤前白细胞计数(p<0.001),白细胞去除率达到了99.97%;血小板损失率为(8.1±4.2)%,明显低于20%的国家标准规定(p<0.001);与过滤前相比,过滤后MVP、机采血小板保存介质中的LDH浓度、K+浓度和pH值无明显变化(p>0.05),过滤后的血小板膜表面CD62p表达率出现轻度下降(p>0.05),但滤盘灌注液内血小板膜表面CD62p表达率却明显高于滤前(p<0.05);过滤后血小板MA值出现轻度下降,但无明显统计学差异(p>0.05)。结论:使用白细胞过滤器可以有效去除机采血小板中混杂的白细胞及部分活化血小板,使血小板损失率控制在较低水平,且对于血小板凝血活性没有产生明显影响。过滤后的机采血小板达到预防巨细胞病毒感染及HLA同种免疫的质量要求。This study was aimed to investigate the effect of leukocyte depletion by filtration on the quality of apheresis platelets. 20 units of donor apheresis platelets were randomly selected and were preserved with agitation at 20 -24℃ for 24 -96 hours, then were filtered on polyester flatbed filters. The platelet concentration, mean platelet volume （MPV）, volume of apheresis platelets, leukocyte count, pH value, lactate dehydrogenase （LDH） concentration, K ^＋ concentration and CD62p expression level on surface of platelet membrane, were detected before and after filtration, as well as the rate of leukocyte depletion and platelet loss were calculated. The results showed that the leukocyte count after filtration was remarkably lower than that before filtration （p 〈 0. 001 ）, and the rate of leukocyte depletion was 99.97%. Platelet loss was approximately 8%, and obviously lower than that of the national standard（p 〈 0. 001 ）. MPV, pH value, K ^＋ and LDH concentration were not significantly different before and after filtration. Compared with platelets before filtration , CD62p expression level after filtration slightly decreased （p 〉 0.05 ）. CD62p expression on surface of platelet membrane in perfusion fluid obtained from filter plate was obviously higher than that before filtration（p 〈0.05 ）. MA of platelet after filtration slightly decreased（p 〉 0.05 ） . It is concluded that leukocyte and partial activited platelets can be removed efficiently by using polyester flatbed filters, and platelet loss is very low. Filtration does not adversely affect coagulation activity of the platelets in vitro. Apheresis platelets after filtration can fulfil qulity requirements to prevent infection of cytomegalovims and HLA alloimmunication.

关 键 词：机采血小板 白细胞过滤 残留白细胞 血小板损失 

分 类 号：R331.143[医药卫生—人体生理学]