全血和成分血内毒素检测评估及其安全控制机制的评价  

Evaluation and Safety Control Mechanism of Endotoxin Detection in Whole Blood and Blood Components

作　　者：鲍自谦[1] 刘怡[1] 

机构地区：[1]深圳市血液中心,广东深圳518035

出　　处：《国际输血及血液学杂志》2013年第3期213-216,共4页International Journal of Blood Transfusion and Hematology

基　　金：深圳市科技计划项目（200603188）

摘　　要：目的通过对全血、成分血内毒素动态监测和细菌培养，评估内毒素水平与细菌培养结果的吻合性；临床输血发热反应与血液内毒素关联性；评价血液细菌及内毒素安全控制机制的有效性。方法选择2009年3月至4月本中心的志愿献血者血液样本300份为研究对象，按样本品种分为3组：全血组（n=50）、悬浮红细胞（RBC）成分血组（n=150）及血小板（PLT）成分血组（n=100）；并选择2009年1月至2月于街头无偿献血的健康志愿者全血样本361份作为对照组，并以对照组内毒素检测结果作为正常人群参考范围。采用动态浊度法内毒素定量检测技术，分别对各组血液保存前、中、后期血液样品进行内毒素含量检测，采用方差分析比较各组血样在不同保存时间段内毒素变化情况，并结合其细菌培养结果进行分析；同时检测临床输血发热反应血样的内毒素水平。结果正常人群血液内毒素参考值为（0～0．193）EU／mL；PLT悬液组与对照组（w=0．635，P=0．0585）与悬浮RBC组与对照组（W=0．334，P=0．583）血样在前、中、后3个时间段的内毒素含量比较，差异均无统计学意义；全血组内毒素含量保存前期与后期、中期与后期之间比较，差异有统计学意义（w=0．860，P＝0．014），全血、成分血内毒素水平为（0．005～0．188）EU／ml，细菌培养结果均为阴性；发生输血发热反应的样本血液内毒素监测水平为（0．023～0．145）EU／mL。结论当全血、成分血细菌培养呈阴性时，其内毒素水平比较均无异常，显示彼此结果吻合；输血发热反应血样的内毒素水平正常，提示与输血发热反应无关联性。现行采供血机构在医用耗材、献血者筛查、血液采集、制备、保存、运输等环节，对血液细菌及内毒素安全控制机制是有效的。Objective Through dynamic monitoring bacterial endotoxin and cultivating whole blood and blood components, consistence between endotoxin level and bacterial culture results, association between the clinic fever reaction and blood endotoxin were evaluated. Furthermore, the effectiveness of safety control mechanism on bacterium and endotoxin was assessed. Methods From March to April 2009, a total of 300 blood samples of volunteer donors from our blood center were included in this study. Based on the sample varieties, all of these samples were divided into 3 groups： the whole blood group （n= 50）, suspended red blood cell （RBC） components group （n= 150） and platelet （PLT） components group （n= 100）. Meanwhile 361 healthy donors from the street during January to February 2009, were chosen as a control group, and their endotoxin results would be used as normal reference range. Dynamic turbidity was used as the quantitative detection method of bacterial endotoxin. Endotoxin content in each group was individually detected during their blood preservations. And the endotoxin content results of each group in different blood preservation period and their bacterial cultivating results were analyzed by variance of repeated measurement data. Moreover, the samples from clinical transfusion fever reaction were detected for endotoxin level. Results Normal blood endotoxin reference range from the control group was （0-0. 193） EU/mL. PI.T suspension group （W^0.635, P=0.0585）, and suspended RBC group （W=0.334, P= 0. 583） had no significant differences in endotoxin concentration of three periods. There were significant differences in endotoxin in whole blood group of three periods （W=0. 860, P=0. 014）. The endotoxin levelof whole blood and blood components was （0. 005-0. 188） EU/mL, and all bacterial cultivating results were negative. Endotoxin concentration in blood samples of transfusion fever reaction was （0. 023-0. 145） EU/ mL. Conclusions While cultivating results of whole blood and blo

关 键 词：全血 成分血 内毒素检测 安全控制 

分 类 号：R4[医药卫生—临床医学]