4℃冷藏保存血小板功能变化  

Functional changes of platelet concentrates stored at 4℃

作　　者：杨江存[1] 高英[2] 孙杨[1] 马婷[1] 尹文[3] 仝小宁 王文华[1] 谢昕昕[1] 陈萍[1] 张小乐[3] 刘凤华[5] 

机构地区：[1]陕西省人民医院输血科,陕西西安710068 [2]陕西省人民医院血液科 [3]第四军医大学西京医院输血科 [4]西安交通大学第一附属医院检验科 [5]哈尔滨医科大学第一附属医院

出　　处：《中国输血杂志》2017年第6期553-557,共5页Chinese Journal of Blood Transfusion

摘　　要：目的对比分析4℃冷藏保存血小板与22℃振荡保存血小板的功能变化,为制定冷藏保存血小板技术提供实验室依据。方法对4℃冷藏保存血小板(实验组)于保存到d1、d3、d5、d7、d10、d14、d21,7个时间点和22℃振荡保存血小板(对照组)在保存到d1、d3、d5、d7,4个时间点进行采集血样,采用血栓弹力图、血小板聚集仪、流式细胞仪对不同保存条件下血小板进行检测。结果 4℃冷藏保存血小板血栓弹力图指标在7d内组间比较无统计学差异(P>0.05),MA值储存d3起逐渐降低,但储存到21 d时,仍在正常值范围内。22℃振荡保存血小板的血栓弹力图5项指标在保存5d内出现低凝趋势(P<0.05)。4℃冷藏保存血小板保存d1后血小板最大聚集率均>50%,高于22℃振荡保存(P<0.05),血小板保存到d5,COLL和ACA诱导的最大聚集率在4℃冷藏保存时仍保持在80%以上,而22℃保存在d5时点,4种诱导剂的聚集率均低于5%。4℃冷藏保存10-14 d时,4种聚集率虽有降低,但仍明显高于22℃保存d5时的聚集率(P<0.05)。血小板表面活化的PAC-1(活化的IIb/IIIa)和CD62P(P-selectin)在4℃冷藏保存到d10-14时仍有大量血小板处于中晚期活化状态,22℃保存到d5时呈现高度晚期活化状态。结论 4℃冷藏保存血小板较22℃振荡保存血小板具有较好的聚集、止血功能和较高的活性,可在体外保存10-14 d。Objective To comparison and analysis the changes in functional of platelets stored at 4℃ and those agitated at 22℃ were compared to provide an experimental basis for the cryopreservation technology of platelets.Methods Blood samples were collected for platelets stored at 4℃ for 1,3,5,7,10,14,and 21 days,as well as for those stored with agitation at 22℃ for 1,3,and 5 days.Thromboelastography（TEG）,light transmittance aggregometry,and flow cytometry were used to test platelets that had been stored under the different conditions.Results The thromboelastograph of platelets stored at 4℃ showed that their MA values were still within the normal range after 21 days of storage.The five TEG indicators of platelets stored with agitation at 22℃ for 5 days showed low coagulation（P〈0.05）.The maximum platelet aggregation rate of platelets stored at 4℃ for 1 day was higher than 50% and was higher than that of platelets stored with agitation at 22℃（P〈0.05）.After 5 days of storage,the COLL-and ACA-induced maximum aggregation rate of platelets stored at 4℃ was maintained at above 80%,while the maximum aggregation rate by the four inducers for platelets agitated at 22℃ was less than5%.For platelets stored at 4℃ for 10-14 days,although the four aggregation rates were reduced,they were significantly higher those of platelets stored with agitation at 22℃ for 5 days（P〈0.05）.Analysis of activated procaspase-activating compound 1（activated IIb/IIIa） and CD62P（P-selectin） on the platelet surface revealed that a large number of platelets stored at 4℃ after 10-14 days remained in the mid and late activation states.Conclusion Platelets stored at 4℃ showed better aggregation,coagulation,and higher activity than platelets stored with agitation at 22℃.Platelets can be stored in vitro for10-14 days.

关 键 词：冷藏保存 血小板功能 血小板活性 

分 类 号：R457.12[医药卫生—治疗学] R331.143[医药卫生—临床医学]