混合浓缩血小板在1种国产一次性滤除白细胞血小板贮存袋中保存质量研究  

Function evaluation of leukocyte-filtered platelet concentrates stored in one type of domestically manufactured disposable platelet storage bags

作　　者：贺曾[1] 韩玎玎 钟锐[1] 张学俊[1] 李燊[1] 周洋[1] 李伟楠[1] 桑培培[1] 刘嘉馨[1] 王红[1] 

机构地区：[1]中国医学科学院北京协和医学院输血研究所,四川成都610052

出　　处：《中国输血杂志》2017年第6期582-586,共5页Chinese Journal of Blood Transfusion

基　　金：四川省科技支撑计划(2014SZ0127)

摘　　要：目的考察浓缩血小板混合后在一次性滤除白细胞血小板贮存袋保存过程中的质量变化。方法采用富血小板血浆法(PRP法)从400 mL新鲜全血制备浓缩血小板,将10-12 U(1 U约30 mL)ABO血型同型的浓缩血小板混合并滤除白细胞后,注入一次性滤除白细胞血小板贮存袋振荡保存,共完成10例(袋);分别于滤除白细胞前、后以及保存d1、d3、d5、d7观察涡流现象,检测pH值、血细胞计数、血小板聚集、血小板低渗休克(HSR)、血小板形变能力(ESC),CD62p阳性表达率、血小板ATP含量、葡萄糖和乳酸含量等指标。结果 1个成人治疗剂量的混合浓缩血小板滤除白细胞后血小板回收率(86.7±1.6)%,HSR(3.87±12.75)%,剩余白细胞数(0.15±0.15)×106个,滤除白血病前、后血小板pH值、HSR(%)和CD62p阳性率(%)分别为7.00±0.17 vs 7.06±0.16、66.96±12.35 vs 63.22±8.26、28.94±14.25 vs 31.60±16.77,花生四烯酸诱导时的聚集率(%)106.2±23.5 vs 106.5±20.1,ADP+肾上腺素诱导时的聚集率(%)104.8±19.0 vs 106.5±18.6(P>0.05)。随着保存时间的延长,混合浓缩血小板的各项指标绝对值发生变化:保存d1及d5(有效保存期末)的pH值、HSR(%)、CD62p(%)及ESC(%)分别为7.27±0.12 vs 7.13±0.21、62.28±6.93 vs 65.53±8.23、30.27±9.06 vs 34.45±14.23、14.28±2.01 vs 8.55±4.12,花生四烯酸诱导时的聚集率(%)92.2±6.1 vs 86.3±23.1,ADP+肾上腺素诱导时的聚集率(%)为93.2±6.7 vs 44.5±41.6。ATP(μmol/1011个血小板)、乳酸(mmol/L)、葡萄糖(mmol/L)分别为5.40±1.66 vs 4.97±1.01、8.35±2.94 vs 13.87±2.97、24.55±1.53vs 20.75±2.04。结论浓缩血小板经混合、滤除白细胞后放入一次性滤除白细胞血小板贮存袋中保存,保存过程中其质量符合国家标准,可以作为临床单采血小板的补充。Objective To characterize the function and quality changes in leukocyte-filtered platelet concentrates（PCs）during storage in vitro.Method PCs were prepared using 400 mL fresh whole blood by the platelet-rich plasma（PRP）method.10-12 U（1 U contains approximately 30 mL platelet concentrates） of ABO-matched PCs were pooled and processed with leukocytes filtration,yielding a total of 10 sample pools.The swirling phenomenon,pH,automatic blood count,platelet aggregation,hypotonic shock response（HSR）,the extent of shape change（ESC）,CD62 p expression,ATP level in platelet,glucose and lactate concentration were analyzed before and 1,3,5 and 7 days post filtration.Results The platelet recovery ratio regarding a single adult therapeutic dose of post-filtration PCs was（86.7±1.6） % while the relative change rate of HSR was（3.87±12.75） %.with a leukocyte residual of（0.15±0.15）×10-6.The pH,HSR（%）,and the CD62 p expression（%） of pooled PCs before and after filtration were 7.00±0.17 vs 7.06±0.16,66.96±12.35 vs 63.22±8.26 and 28.94± 14.25 vs 31.60±16.77 while platelet aggregation induced by arachidonic acid（%） and ADP ＋epinephrine（%） were 106.2±23.5 vs 106.5±20.1,104.8±19.0 vs 106.5±18.6,suggesting no significant changes caused by the filtration（P〉0.05）.The biochemical indicators of pooled PCs changed as the storage time increased：comparing the samples of day 1 to the ones of day 5,the pH,HSR（%）,CD62 p expression（%） and ESC（%） were 7.27±0.12 vs 7.13±0.21、62.28±6.93 vs 65.53±8.23、30.27±9.06 vs 34.45±14.23、14.28±2.01 vs 8.55±4.12.Platelet aggregation ratios induced by arachidonic acid（%） were（92.2±6.1） vs 86.3±23.1 and aggregation ratios induced by ADP＋epinephrine were 93.2±6.7 vs 44.5±41.6.ATP levels in the platelets（μmol/1011Plt）,glucose（mmol/L）and lactate（mmol/L） concentration were 5.40±1.66 vs 4.97 ±1.01、8.35±2.94 vs 13.87± 2.97、24.55±1.53 vs 20.75±2.04 respectively.Conclusion The quality of the l

关 键 词：血小板保存 混合浓缩血小板 白细胞过滤 血小板贮存袋 血小板质量 

分 类 号：R331.13[医药卫生—人体生理学] R446.113[医药卫生—基础医学]