常温和冰冻保存条件下单采血小板制品凝血功能的差异  

Differences in coagulation function between room temperature preserved versus cryopreserved platelet products by apheresis

作　　者：钟周琳 周燕 卢芳 李丽兰 李恒聪 蒋丽红 陈洁润 吴国光 ZHONG Zhou-lin;ZHOU Yan;LU Fang;LI Li-lan;LI Heng-cong;JJANG Li-hong;CHEN Jie-run;WU Guo-guang(Nanning Institute of Transfusion Medicine,Nanning 530007,China)

机构地区：[1]广西南宁输血医学研究所,南宁市530007

出　　处：《广西医学》2020年第16期2062-2065,共4页Guangxi Medical Journal

基　　金：广西自然科学基金(2016GXNSFAA380144);广西南宁市科学研究与技术开发计划(20173117)。

摘　　要：目的探讨常温(22±2)℃振荡、-80℃冰冻保存下单采血小板制品凝血功能的差异。方法随机选取16份单采血小板,应用无菌接管技术将每份单采血小板样本分成8份。其中4份于(22±2)℃常温振荡保存,分别在采集当日、第3天、第5天、第8天进行检测;另4份置于冻存管中-80℃保存,分别在采集后第3天、第5天、第8天及1年进行检测。采用血细胞计数仪检测血小板计数、平均血小板体积(MPV),采用血栓弹力图检测凝血时间、α角、最大振幅、凝血指数,采用流式细胞术检测血小板CD62P表达水平、膜联蛋白V(Annexin V)结合率。结果采集后各时点,随着保存时间增加,常温保存的血小板凝血时间延长而凝血指数降低,但冰冻保存的血小板凝血时间缩短而凝血指数增高;与常温保存的血小板比较,冰冻保存的血小板的各时点凝血时间更短,而采集后第5天、第8天的凝血指数更高(均P<0.05)。采集后各时点,两种保存条件下血小板的CD62P表达水平和Annexin V结合率均随着保存时间增高;与常温保存的血小板比较,冰冻保存的血小板各时点的Annexin V结合率更高,采集后第5天、第8天的CD62P表达水平更低(均P<0.05)。采集后各时点,两组的血小板计数、MPV、最大振幅、α角差异均无统计学意义(均P>0.05)。结论冰冻保存的单采血小板具有更稳定的凝血功能,保存期长,可作为常温保存单采血小板制品的补充。Objective To explore the differences in coagulation function between room temperature(22±2℃)vibrationally preserved versus cryopreserved(-80℃)platelet products by apheresis.Methods Sixteen samples of apheresis platelets were randomly collected,and one sample of apheresis platelets was divided into eight portions under aseptic conditions using the tube-connecting technology.Among them,four portions were vibrationally preserved at room temperature(22±2℃),and were detected on the right day,the 3rd,5th and 8th day of harvest,respectively;another four portions were cryopreserved(-80℃)in cryopreservation tube,and were detected on the 3rd,5th,8th day and one year after harvest,respectively.Blood cell counter was used to determine platelet count and mean platelet volume(MPV),thromboelastography was used to detect coagulation time,αangle,maximum amplitude and coagulation index,flow cytometry was employed to determine platelet CD62P expression level and Annexin V binding rate.Results At all time points after harvest,with the increase of preservation time,coagulation time prolonged and coagulation index decreased in room temperature preserved platelets,whereas coagulation time decreased and coagulation index increased in cryopreserved platelets;compared with room temperature preserved platelets,cryopreserved platelets exhibited shorter coagulation time at all time points as well as higher coagulation index on the 5th and 8th day after harvest(all P<0.05).At all time points after harvest,CD62P expression level and Annexin V binding rate increased with the increasing preservation time in platelets under two different preservation conditions;compared with room temperature preserved platelets,cryopreserved platelets had higher Annexin V binding rate at all time points,and decreased CD62P expression level on the 5th or 8th day after harvest(all P<0.05).There were no statistically significant differences between the two groups in platelet count,MPV,maximum amplitude orαangle at any time point after harvest(all P>0.05)

关 键 词：血小板制品 常温保存 冰冻保存 凝血功能 血栓弹力图 CD62P 膜联蛋白V结合率 

分 类 号：R457.1[医药卫生—治疗学]