影响冷沉淀质量的因素探讨  

A comparative study of theinfluencing factors on factor Ⅷ activity in cryoprecipitate

作　　者：张良子 苏晓敏 张雅莉[1] ZHANG Liangzi;SU Xiaomin;ZHANG Yali(Blood Center of Shaanxi Province,Xian Blood Center,Xian 710000,China)

机构地区：[1]陕西省血液中心西安市中心血站,陕西西安710000

出　　处：《中国输血杂志》2020年第6期572-575,共4页Chinese Journal of Blood Transfusion

摘　　要：目的研究影响冷沉淀凝血因子质量最显著的因素,优化制备工艺,提高冷沉淀产率。方法符合《献血者健康检查要求》13 min内采完(保存液为ACD-B及保存液为CPDA-1)400 mL全血214份,分离制备冷沉淀。首先比较ACD-B血袋制备的A、B、O、AB各型冷沉淀(每组15份);对比ACD-B、CPDA-1 2种血袋制备的非O型冷沉淀(每组17份);再比较凝血因子Ⅷ≥80 IU与<80 IU ACD-B血袋制备的非O型冷沉淀血浆游离血红蛋白含量和pH值的差异(每组15份);最后,分为实验组和对照组,实验组非O型全血采集后采用1种水循环方式快速降温至4℃后置于2—6℃储血冰箱;对照组非O型全血采集后直接放入2—6℃储血冰箱。先比较2组均在采血后18—24 h制备的冷沉淀(每组15份),再观察实验组在采血后0—6 h、6—12 h、12—18 h、18—24 h冷沉淀凝血因子Ⅷ活性的动态变化(每组30份)。结果冷沉淀中凝血因子Ⅷ活性以B型[(94.81±14.95)IU/袋]、AB型组[(96.94±24.16)IU/袋]明显高于O型组[(77.68±10.41)IU/袋,P<0.05],Fib无差异(P>0.05);ACD-B、CPDA-12种血袋制备的非O型冷沉淀凝血因子Ⅷ活性[ACD-B:(91.58±26.69)IU/袋、CPDA-1:(107.68±29)IU/袋]、Fib含量[ACD-B:(218.67±44.85)mg/袋,CPDA-1:(244.62±40.02)mg/袋]无差异(P>0.05);非O型冷沉淀凝血因子Ⅷ≥80 IU与凝血因子Ⅷ<80 IU相比,血浆游离血红蛋白含量[Ⅷ≥80 IU:(32.37±10)mg/L,Ⅷ<80 IU:(30.71±10.35)mg/L]、pH值[Ⅷ≥80 IU:(7.183±0.18),Ⅷ<80 IU:(7.181±0.16)]无差异(P>0.05);实验组在采血后18—24 h制备冷沉淀凝血因子Ⅷ活性(99.15±24.25 IU/袋)高于对照组[(79.78±24.35)IU/袋,P<0.05],Fib含量[对照组:(213.72±32)mg/袋,实验组:(218.67±44.85)mg/袋]无差异,均符合现行《全血及成分血质量要求》,对照组的冷沉淀凝血因子Ⅷ活性不符合,Fib含量符合;实验组分别在采血后0—6 h、6—12 h、12—18 h、18—24 h制备冷沉淀,凝血因子Ⅷ活性随着制备时间延长而递减,并且均符�Objective To assess the effect of temperature, time and blood type on FⅧ activity in cryoprecipitate produced in our blood center, so as to optimize the producing process of cryoprecipitate aiming at enhancing its yield and preventing a reduction of FⅧ activity.Methods 214 units of whole blood(400 mL), which were collected within 13 mintues(conserved with ACD-B or CPDA-1) and met the requirements of Health Examination Criteria of Blood Donors were separated for the preparation of cryoprecipitate. Firstly, the relationship between blood group and FⅧ content was assessed by selecting an equal number of group A, group B, group O and group AB donations conserved with ACD-B(15 units/group). Next, 17 units of non-O group cryoprecipitate for each group, conserved with ACD-B and CPDA-1 respectively, were chosen to compare the FⅧ contents between the two groups. Then, the differences between free hemoglobin(FHb) and the pH value of non-O cryoprecipitate with FⅧ≥80 IU and FⅧ<80 IU were compared. Last, experimental group and control group were kept at two different temperatures after collection. For experimental group, non-O-group donations were cooled rapidly to 4℃ prior to 2—6℃ freezer storage. While non-O-group donations in control group were put into 2—6℃ freezer after collection without delay. The yield of cryoprecipitate prepared within 18—24 h after collection between experimental group and control group was compared. The FⅧ content of cryoprecipitate in experimental group for periods of 0—6, 6—12, 12—18 or 18—24 hours after collection was measured(30 samples/group).Results FⅧ activity(IU/unit) in cryoprecipitate from group B(94.81±14.95) and group AB(96.94±24.16) was significantly higher than that in group O(77.68±10.41)(P<0.05).The activity of Fib had no significant differences among plasma with different blood groups. For non-O-group cryoprecipitate conserved with ACD-B or CPDA-1,no significant differences were seen between them in FⅧ activity(IU/unit)(ACD-B:91.58±26.69

关 键 词：冷沉淀 温度 凝血因子Ⅷ 纤维蛋白原 

分 类 号：R457.1[医药卫生—治疗学] R392.33[医药卫生—临床医学]