连续流动离心式血液成分分离机高量减除白细胞治疗的采集效果评价  

Clinical research:evaluation of the effectiveness of continuous flow centrifuge and blood component separator on the reduction therapy of leukocytes

作　　者：吴勇[1] 吴远军[1] 李惠森 刘艳[1] 陈宝婵[1] 吴月勤[1] 王前[1] 吴东升[1] 刘兴玲[2] 

机构地区：[1]中山大学附属东华医院,广东东莞523110 [2]南方医科大学附属东莞市石龙人民医院

出　　处：《中国输血杂志》2015年第1期45-48,共4页Chinese Journal of Blood Transfusion

摘　　要：目的探讨采用连续流动离心式血液成分分离机,对高白细胞性白血病患者进行高量减除白细胞治疗的采集效果。方法采用COBE Spectra连续流动离心式血液成分分离机MNC程序,以ACD-A配方血液保存液作为抗凝剂,对高白细胞性白血病患者实施减除白细胞治疗,每次治疗处理2.5-3.0倍总血容量,采集1/5-1/4倍总血容量的白细胞悬液,对39名患者共进行56次减除白细胞治疗。结果单次治疗运行时间(233.63±27.41)min;处理血量(12 268.77±1 978.25)m L;ACD-A配方血液保存液用量(991.04±185.06)m L;采集白细胞悬液容量(922.89±213.26)m L,悬液中白细胞计数551.05×109/L[(396.76-756.45)×109/L],白细胞总数491.52×109[(341.53-754.51)×109],据此计算可减低患者血液白细胞计数(白细胞减除值)111.35×109/L[(80.98-158.18)×109/L];单次治疗前、后患者白细胞计数分别为233.30×109/L[(163.62-367.05)×109/L]、167.34×109/L[(94.40-260.06)×109/L](s=765,P<0.001),治疗后白细胞计数减低值53.35×109/L[(35.72-107.03)×109/L],低于计算的白细胞减除值(s=681,P<0.001);治疗结束时增、减液体容量与患者总血容量的比值为8.22%(4.76%-11.83%)。结论采用连续流动离心式血液成分单采技术,可在保持患者循环动力学相对稳定的前提下对高白细胞性白血病患者进行高量(1/5-1/4倍总血容量)减除白细胞治疗,显著降低患者体内白细胞负荷;减除患者白细胞总数比患者外周血白细胞计数的减低值,对评价减除白细胞治疗的效果更有意义。Objective To explore the effect of continuous flow centrifuge （CFC） and blood component separator on leu- kocyte （WBC） reduction therapy for patients with hyperleukocytic leukemia （HLL）. Methods After patients with HLL were treated with ACD-A preservation solution as blood anticoagulant, the MNC program was conducted by COBE Spectra of CFC, and WBC reduction therapy was performed. In each treatment, 2.5 -3.0 times of total blood volume （TBV） circula- ted, and the WBC suspension within 20% -25% volume of TBV was collected. Fifty six WBC reduction treatments were performed in 39 patients with HLL. Results A single treatment took （233.63± 27.41 ） minutes in which （ 12268. 77 ± 1978. 25） mL blood circulated, （991.04 ± 185.06） mL of ACD-A preservation solution was used, and （922. 89 ±213. 26） mL of WBC suspension was collected. In the suspension, the WBC count was 551.05 （396. 76,756.45） × 109/L, contai- ning 491.52 （341.53,754. 51） × 109 WBC. In the single treatment, WBC count was reduced by 111.35 （80. 98, 158. 18） × 109/L. Before treatment and after treatment, the patients＇ WBC counts were 233.30 （163.62, 367. 05 ） × 109/L and 167.34 （94.40, 260.06） × 109/L, respectively. （s =765,P 〈0.001）. Treatment reduced the WBC count by 53.35 （35.72, 107.03） × 109/L, less than the calculated reduction （s = 681, P 〈 0. 001 ）. At the end of the treatment, the ratio of liquid volume increase or reduction and TBV was 8.22 （4.76, 11.83 ） % ： Conclusion While keeping a relatively stable blood circulation dynamic in patients with HLL, the application of WBC depletion therapy and leukapheresis technology by CFC was able to effectively decrease the high proportions of WBC load. The effect of WBC depletion therapy was significant. The reduction of total numbers of WBC is more valuable than the reduction of leukocyte count in peripheral blood.

关 键 词：血液成分分离机 白血病 白细胞单采 

分 类 号：R457.1[医药卫生—治疗学] R733.71[医药卫生—临床医学]