4℃冷藏保存血小板对体外大失血模型的纠正效果  

Corrective effects of 4℃ stored platelets with a hemorrhage modeling in vitro

作　　者：韩宇枫[1] 杨江存[2] 马婷[2] 孙杨[2] 尹文[3] 谢昕昕[2] 王文华[2] 宋耀军[2] 陈萍[2] 胡兴斌[3] 张小乐[3] 李淑萍[4] 

机构地区：[1]陕西省人民医院妇产病院,陕西西安710068 [2]陕西省人民医院 [3]第四军医大学西京医院 [4]北京同仁医院

出　　处：《中国输血杂志》2017年第6期567-572,共6页Chinese Journal of Blood Transfusion

摘　　要：目的探讨4℃冷藏保存血小板对体外大失血模型的纠正效果。方法手工汇集(10人份)血小板200mL等分为2×100 mL,分别于4℃冷藏保存和22℃振荡保存,共计制备5×200 mL,等分后放置4℃冷藏冰箱和22℃血小板振荡保存箱。采用血液稀释法(全血∶盐水=1∶9)制备体外大失血模型,应用TEG检测指标及血常规等指标对比、评价悬浮红细胞、新鲜冰冻血浆与4℃冷藏保存血小板(简称4℃血小板)或22℃振荡保存血小板(简称22℃血小板)按1∶1∶1比例对体外大失血模型的纠正效果。结果保存1、3、5 d时,4℃血小板组和22℃血小板组在对相同血样制备的体外失血模型纠正,Plt(×109/L)从20-27分别升至127-161 vs 128-160(P>0.05),TEG-MA值(mm)由12.7-14.4分别升至45-51 vs 47-50,TEG-R值(min)由27.7-9.9分别升至4.4-4.3 vs 4.5-4.7(P>0.05)。保存7-14 d,4℃血小板组:Plt(×109/L)由18-27纠正到162-161,TEG-MA值(mm)由8.8-14.5纠正为46-43,TEG-R值(min)由24-13纠正为5.5-5.2(P<0.05)。结论按悬浮红细胞、新鲜冰冻血浆和4℃冷藏保存血小板作用于体外大失血模型达到了纠正效果,佐证了4℃冷藏保存10-14 d的血小板具有良好的止血效果。Objective To evaluate the corrective effects of platelets stored at 4℃ with the help of a in vitro hemorrhage model.Platelets agitated at 22℃ were used as comparison.we hope this study would provide valuable experimental bata for the preservation of platelets in clinical applications.Methods Sample platelets with a total volume of 5×200 mL were divided into 2×100 mL each 200 mL for storage at 4℃ and 22℃,respectively.An in vitro model of hemorrhage was established with the in vitro hemodilution method where blood was diluted with normal saline（NS） with a ratio of 1∶9.The in vitro corrective effects of the platelets stored at 4℃ and 22℃ were evalutaed by Thromboelastography（TEG） test and routine blood marker level tests,where these two groups of platelets were prepared in a mix of suspended erythrocytes and fresh frozen plasma with a ratio of 1∶1∶1.Results Platelets stored at 4℃ and those agitated at 22℃ for 1,3,and 5 days were determined to be corrected in the in vitro hemorrhagie model,where platelet counts（×10^9/L） were corrected from 20-27 to 127-161 and 128-160,respectively（P 〉0.05）.The TEG-MA（mm） were corrected from 12.7-14.4 to 45-51 and 47-50 while TEG-R values were corrected from 27.7-9.9 to 4.4-4.3 and 4.5-4.7,respectively（P〈0.05）.For platelets stored at 4℃ for 7-14 days,platelet counts（×10^9/L） were corrected from 18-27 to 162-161 and TEG-MA（mm） were corrected from 8.8-14.5 to 46-43 with TEG-R（min） corrected from 24-13 to 5.5-5.2（P〈0.05）.Conclusion Correction has been detected using the hemorrhage model.The platelet counts,TEG-R,and TEG-MA values have been corrected,thus supporting the claim that platelets stored at 4℃ for 10-14 days presents fine coagulation quality.

关 键 词：血小板 大失血模型 失血纠正 止血 冷藏保存 振荡保存 

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