去白细胞单采血小板保存期末的凝血因子活性及血栓弹力图分析  

Analysis on coagulation factors and thrombelastography of leukocytes reduced apheresis platelets during final storage period

作　　者：赵丙全 焦安秀 陈凯 Zhao Bingquan;Jiao Anxiu;Chen Kai(Rizhao Blood Center,Rizhao 276800,Shandong Province,China)

机构地区：[1]山东省日照市中心血站,276826

出　　处：《国际输血及血液学杂志》2020年第3期257-261,共5页International Journal of Blood Transfusion and Hematology

摘　　要：目的分析去白细胞单采血小板保存期末的凝血因子活性及血栓弹力图(TEG),为指导去白细胞单采血小板临床输注提供参考。方法于2017年6月至2019年6月,采用随机抽样法选择日照市中心血站采集的65人份去白细胞单采血小板为研究对象。去白细胞血小板采用MCS+型血细胞分离机及其配套管路耗材采集。分别于去白细胞单采血小板保存前、(22±2)℃振荡保存第5天和第7天时,对其血小板计数、FⅧ活性、FⅨ活性和TEG进行检测。对以上指标3个不同保存时间点的总体比较,采用单因素重复测量方差分析;不同时间点的两两比较,采用最小显著性差异(LSD)法。本研究遵循的程序符合2013年修订的《世界医学协会赫尔辛基宣言》要求。结果①本研究65人份去白细胞单采血小板,于保存前、保存第5天和第7天时,血小板计数分别为(10.8±0.5)×1011/L、(8.7±1.1)×1011/L、(8.2±1.5)×1011/L,FⅧ活性分别为(105.9±38.2)%、(57.2±22.4)%、(30.5±17.5)%,FⅨ活性分别为(97.8±27.5)%、(54.9±19.7)%、(38.4±12.4)%。保存前、保存第5天和第7天时,上述3项指标分别总体比较,差异均有统计学意义(F=93.90,P<0.001;F=126.16,P<0.001;F=141.04,P<0.001);保存第5天与保存前分别比较,差异均有统计学意义(LSD-t=10.52,P<0.001;LSD-t=10.13,P<0.001;LSD-t=11.76,P<0.001),保存第7天与第5天分别比较,差异亦均有统计学意义(LSD-t=2.34,P=0.020;LSD-t=5.53,P<0.001;LSD-t=4.50,P<0.001)。②65人份去白细胞单采血小板,于保存前、保存第5天和第7天时,TEG参数R值、K值、α角、MA值依次分别为(8.8±0.5)min、(14.1±0.7)min、(16.1±0.6)min,(1.7±0.1)min、(1.8±0.5)min、(1.9±0.6)min,(69.7±3.4)°、(69.1±1.8)°、(69.2±2.6)°,(86.7±2.6)mm、(82.2±3.1)mm、(80.5±3.3)mm;R值、K值、MA值分别总体比较,差异均有统计学意义(F=2522.59,P<0.001;F=3.15,P=0.045;F=73.42,P<0.001)。其中,保存第5天与保存前比较,R值显著升高,MA值显著降低,并且Objective To evaluate the coagulation factors and thrombelastography(TEG)of leukocytes reduced apheresis platelets during the final storage period,in order to guide the reasonable clinical transfusion of leukocytes reduced apheresis platelets.Methods From June 2017 to June 2019,a total of 65 leukocytes reduced apheresis platelets collected from Rizhao Blood Center were selected into this study by random sampling method.The leukocytes reduced platelets were collected by MCS+blood cell separator and its matching pipeline consumables.The platelet count,FⅧactivity,FⅨactivity,and TEG of leukocytes reduced apheresis platelets were tested before storage,at(22±2)℃shaking storage on the 5th and 7th day.The overall comparison of above indicators at 3 different time points used one-way repeated measurement analysis of variance;and the pairwise comparison of different time points used the least significant difference(LSD)method.The procedures followed in this study were in accordance with the requirements of the World Medical Association Declaration of Helsinki revised in 2013.Results In this study,before storage,on the 5th and 7th day of storage,the platelet count of 65 leukocytes reduced apheresis platelets were(10.8±0.5)×1011/L,(8.7±1.1)×1011/L,(8.2±1.5)×1011/L,FⅧactivity were(105.9±38.2)%,(57.2±22.4)%,(30.5±17.5)%,FⅨactivity were(97.8±27.5)%,(54.9±19.7)%,(38.4±12.4)%,respectively.Before storage,on the 5th and 7th day of storage,the above 3 indicators were compared,and the overall differences were statistically significant(F=93.90,P<0.001;F=126.16,P<0.001;F=141.04,P<0.001).The differences of above 3 indicators between the 5th day of storage and before storage(LSD-t=10.52,P<0.001;LSD-t=10.13,P<0.001;LSD-t=11.76,P<0.001),all and between the 7th day and 5th day of storage(LSD-t=2.34,P=0.020;LSD-t=5.53,P<0.001;LSD-t=4.50,P<0.001),all were statistically significant.②Before storage,on the 5th and 7th day of storage,the TEG parameters R value,K value,αangle,and MA value of the 65 leukocytes reduced aphe

关 键 词：血小板去除法 血液凝固因子 因子Ⅷ 因子Ⅸ 血栓弹力描记术 血小板输注 去白细胞单采血小板 

分 类 号：R457.1[医药卫生—治疗学]