贮存式自体输血对急性失血性休克兔骨髓造血细胞的影响  

Effect of preoperative autologous blood donation on the bone marrow hematopoietic cells in acute hemorrhagic shock rabbits

作　　者：章健萍 刘丽[1] 陶强[1] 杨大威[1] 郭建荣[1] 

机构地区：[1]第二军医大学附属公利医院麻醉科,上海市200135

出　　处：《临床麻醉学杂志》2016年第10期988-992,共5页Journal of Clinical Anesthesiology

基　　金：国家自然科学基金(81671919);上海市卫生计生委面上项目(201440456);上海市浦东新区医学领先人才项目(PWR12013-03)

摘　　要：目的探讨贮存式自体输血（PABD）对急性失血性休克新西兰家兔骨髓造血细胞的影响。方法雄性新西兰家兔24只,体重1.9~2.4kg,采用随机数字表法分为四组：对照组（CON组）、异体输血组（ABT组）、自体采血组（ABS组）及贮存式自体输血组（PAT组）,每组6只。ABS组和PAT组模拟休克前进行3次自体血采集贮存,每次间隔1周,至休克前72h完成。CON组和ABS组进行股动脉分离不模拟休克,ABT组和PAT组兔急性失血性休克模型建立后,ABT组输入ABS组贮存的血液进行复苏,PAT组输入术前贮存的自体血液进行复苏。在血液贮存前（T1）、血液贮存后（T2）、休克前（T3）、复苏后即刻（T4）及复苏后24h（T5）测定四组家兔外周血的Hb、网织红细胞（RET）比例,复苏后24h抽取兔骨髓测定有核细胞计数和骨髓细胞静止期/合成前期（G0/G1）、合成期（S）、合成后期/分裂期（G2/M）各期所占比例。结果 T2~T5时ABS组,T2、T3时PAT组,T4时ABT组Hb浓度明显低于CON组（P〈0.05）。T2~T5时ABS组和PAT组RET比例明显高于CON组和ABT组（P〈0.05）。T5时ABS组和PAT组骨髓有核细胞计数分别为[（6.30±1.75）×10^7/ml]、[（5.64±2.42）×10^7/ml],明显高于CON组的[（3.16±1.09）×10^7/ml]和ABT组的[（2.28±0.92）×10^7/ml]（P〈0.05）。ABS组和PAT组骨髓细胞G0/G1期比例明显低于CON组和ABT组,S期比例明显高于CON组和ABT组,G2/M期比例明显高于ABT组（P〈0.05）;ABT组骨髓细胞G0/G1期比例明显高于CON组,S期和G2/M期比例明显低于CON组（P〈0.05）。结论贮存式自体输血能够通过刺激骨髓造血细胞由静止期进入增殖分裂期,增加网织红细胞比例,促进术后血红蛋白的早期恢复。Objective To explore the effect of preoperative autologous blood donation on the bone marrow hematopoietic cells in acute hemorrhagic shock of New Zealand rabbits.Methods Twenty-four male New Zealand rabbits,weighing 1.9-2.4kg,were randomly divided into 4groups（n=6each）,using a random number table：control group（group CON）,allogeneic blood transfusion group（group ABT）,autologous blood storage group（group ABS）and preoperative autologous blood donation group（group PAT）.In ABS and PAT groups,autologous blood was collected and stored for 3times before operation,once a week till 72 hours before operation.Femoral artery of group CON and group ABS were separated,yet shock was not simulated.After the rabbit model of acute hemorrhagic shock was established,group ABT was transfused the blood stored by group ABS,group PAT preoperative autologous blood.Hemoglobin（Hb）and reticulocyte（RET）percentage of the four groups of rabbits were tested before blood storage（T1）,after blood storage（T2）,before hemorrhagic shock（T3）,at resuscitation（T4）,resuscitation for 24h（T5）.The bone marrow nucleated cell of rabbits was counted and the proportion of marrow hematopoietic cell in stationary/first gap（G0/G1）phase,synthesis（S）phase,second gap/mitosis（G2/M）phase was examined at 24 hafter resuscitation.Results Compared with group CON,Hb was significantly decreased in group ABS at T2-T5,group PAT at T2,T3,group ABT at T4（P〈0.05）.Compared with group ABT,RET percentage was significantly increased in group ABS and PAT at T2,and remained at a high level at T5（P〈0.05）.The number of bone marrow nucleated cell was significantly increased in group ABS and PAT（P〈0.05）,the marrow hematopoietic cell cycle of G0/G1 phase was significantly decreased,S phase,G2/M phase cell proportion obviously advanced（P〈0.05）.Conclusion Preoperative autologous blood donation stimulates the bone marrow hematopoietic cell from the stationary phase to proliferation,increases the percentage of

关 键 词：贮存式自体输血 失血性休克 骨髓细胞 有核细胞计数 

分 类 号：R614[医药卫生—麻醉学]