急性白血病完全缓解期患者血小板深低温保存后功能变化  

Changes of autologous platelet function after being cryopreservated in patients with complete remission of acute leukemia

作　　者：宋雪珍 任小宁[1] 宋雪梅 王明静 王国礼[1] SONG Xue- zhen REN Xiao- ning SONG Xue- mei WANG Ming- jing WANG Guo- li(Weihai Municipal Hospital of Dalian Medical University, Weihai, Shandong 264200, Chin)

机构地区：[1]大连医科大学附属威海市立医院,山东威海264200 [2]威海市中心血站,山东威海264200

出　　处：《中国卫生检验杂志》2017年第1期37-39,共3页Chinese Journal of Health Laboratory Technology

基　　金：山东省威海市科学技术发展计划项目(2015GNS049)

摘　　要：目的探讨急性白血病完全缓解期患者自体血小板深低温保存后,血小板功能和数量的变化,为临床使用自体冻存血小板提供实验室依据。方法应用血栓弹力图、流式细胞术和全血细胞分析仪,分析54份来自急性白血病诱导化疗后完全缓解、同时微小残留病(minimal residual disease,MRD)阴性患者的自体血小板样本,在-80℃保存30 d,其血小板功能及数量的变化。结果凝血因子水平(R值)和纤维蛋白原水平(K值,α角)变化不明显,但血小板聚集功能(MA值)明显增强,差异有统计学意义(P<0.05)。新鲜血小板组的CD42b表达率较高,为(92.23±3.59)%;经深低温保存,37℃水浴复融后冰冻保存血小板组的CD42b表达率降低为(52.67±7.79)%,差异有统计学意义(t=24.96,P<0.05)。冰冻保存血小板组PLT较新鲜血小板组减少;而PDW和MPV较新鲜组增大,差异均有统计学意义(P<0.05)。结论急性白血病完全缓解期患者采集自体血小板经-80℃冰冻保存和复融,血小板数量有部分减少,但仍然满足回输要求,同时血小板聚集功能增强,对预防或治疗严重骨髓抑制期出血具有保护作用,值得临床推广应用。Objective To investigate the changes of autologous platelet in function and quantity after being cryopreservated in patients with complete remission（ CR） of acute leukemia（ AL）,so as to provide laboratory evidence for clinical application.Methods Thrombelastography,flow cytometry and whole blood cell analysis were applied to detect 54 copies of autologous platelet from CR of AL,and MRD negative patients. Meanwhile the changes of platelet in function and quantity were analyzed at-80 ℃ for 30 d. Results Coagulation factor level（ R） and fibrinogen level（ K,α angle） changes were not obvious,but platelet aggregation function（ MA） increased significantly,with the difference statistically significant（ P 0. 05）. The expression rate of CD42 b in fresh platelet group was higher,accounting for（ 92. 23 ± 3. 59） %; after cryopreservation,expression rate of CD42 b in the group of water bath thawing after cryopreserved platelet at 37 ℃ decreased to（ 52. 67 ± 7. 79） %,and the difference was statistically significant（ t = 24. 96,P 0. 05）. Compared with fresh group,the PLT of cryopreserved platelet group decreased,while PDW and MPV increased significantly,with the differences statistically significant（ P 0. 05）. Conclusion Complete remission of acute leukemia patients with autologous platelets collection by-80 ℃ storage and thawing,some reduction in platelet quantity,but still meet the transfusion requirements. At the same time,the increase of platelet aggregation,prevention or treatment of severe bone marrow suppression henmorrhage has a protective effect,and it is worthy of clinical application.

关 键 词：急性白血病 自体血小板 血小板功能 血小板数量 深低温保存 

分 类 号：R457.12[医药卫生—治疗学]