贮存式自体全血与单纯红细胞输注对家兔骨髓造血干细胞功能的影响  

Effect of preoperative autologous whole blood and simple red blood cells donation and transfusion on the function of rabbit bone marrow hematopoietic stem cells

作　　者：段立双 王欢 周循 卫含伟 李振洲 徐佳明 郭建荣 DUAN Lishuang;WANG Huan;ZHOU Xun;WEI Hanwei;LI Zhenzhou;XU Jiaming;GUO Jianrong(Department of Anesthesiology,Gongli Hospital,Naval Medical University,Shanghai 200135,China)

机构地区：[1]海军军医大学附属公利医院麻醉科,上海市200135

出　　处：《临床麻醉学杂志》2021年第3期290-295,共6页Journal of Clinical Anesthesiology

基　　金：上海市浦东新区卫生系统重点学科群建设项目(PWZxq2017-10);国家自然科学基金(81671919,81870147)。

摘　　要：目的探讨贮存式自体全血和红细胞成分对骨髓造血干细胞衰老相关指标的影响。方法健康雄性新西兰家兔30只,3~6月龄,体重2.5~3.0 kg。采用随机数表法将其分为五组:对照组(C组)、单纯手术组(S组)、手术采血组(ABS组)、贮存式自体全血输注组(PAB组)和贮存式自体红细胞输注组(PARB)组,每组6只。C组家兔麻醉后,不做任何处理,按时点采集骨髓标本,其余各组均开腹行肝叶切除,ABS组、PAB组和PARB组于术前1周采血贮存,S组和ABS组术中输液补充血容量,PAB组和PARB组术中分别输注贮存的自体全血和自体红细胞。于麻醉诱导后手术前(T_(1))、术后6 h(T_(2))和术后24 h(T_(3))采集骨髓样本测定家兔CD34^(+)细胞百分比、活性氧(ROS)浓度、衰老细胞比例及衰老相关蛋白(p53、p21)的表达情况。结果与T_(1)时比较,T_(2)、T_(3)时S组、ABS组、PAB组和PARB组的CD34^(+)细胞百分比明显升高,ROS浓度、衰老细胞比例明显降低,T_(2)时ABS组,T_(2)、T_(3)时S组、PAB组和PARB组p53、p21蛋白含量明显降低(P<0.05)。与T_(2)时比较,T_(3)时S组、ABS组、PAB组和PARB组的CD34^(+)细胞百分比明显升高,T_(3)时PARB组衰老细胞比例明显降低,T_(3)时ABS组、PAB组和PARB组p53蛋白含量明显升高,T_(3)时ABS组和PAB组p21蛋白含量明显升高(P<0.05)。与C组比较,T_(2)、T_(3)时S组,T_(1)—T_(3)时ABS组、PAB组和PARB组的CD34^(+)细胞百分比明显升高,ROS浓度、衰老细胞比例及p53、p21蛋白含量明显降低(P<0.05)。与S组比较,T_(1)时ABS组,T_(1)—T_(3)时PAB组和PARB组CD34^(+)细胞百分比明显升高,T_(1)—T_(3)时ABS组、PAB组和PARB组的ROS浓度明显降低,T_(1)、T_(2)时ABS组,T_(1)—T_(3)时PAB组和PARB组衰老细胞比例和p53、p21蛋白含量明显降低(P<0.05)。与ABS组比较,T_(2)、T_(3)时PAB组和PARB组的CD34^(+)细胞百分比明显升高,T_(1)—T_(3)时PAB组和PARB组的ROS浓度明显降低,T_(2)、T_(3)时PAB组和PARB组衰老细�Objective To study and evaluate the effect of autologous whole blood and red blood cells donation and transfusion on aging-related indexes of bone marrow hematopoietic stem cells.Methods Thirty healthy male New Zealand rabbits,aged 3-6 months,weighing 2.5-3.0 kg,were randomly divided into 5 groups(n=6):control group(group C),simple surgery group(group S),simple blood collection group(group ABS),stored autologous whole blood transfusion group(group PAB),and the storage autologous red blood cell transfusion group(group PARB).After anesthetized,the rabbits in group C were collected bone marrow specimens on time without other treatment.Other groups of rabbits underwent hepatectomy.And 10%of whole blood storage was collected from groups ABS,PAB and PARB one week before surgery.Then,rabbits in groups S and ABS were infused with lactated ringer s solution to supplement blood volume during operation,while the rabbits in groups PAB and PARB were infused with stored autologous whole blood and autologous red blood cells.The percentage of bone marrow CD34^(+)cells,Ros concentration,proportion of senescent cells and the expression of senescence-associated proteins(p53,p21)in hematopoietic stem cells were detected after induction of anesthesia before surgery(T_(1)),6 hours after surgery(T_(2))and 24 hours after surgery(T_(3)).Results Compared with T_(1),the percentage of CD34^(+)cells were increased while the ROS concentration and the proportion of senescent cells were decreased significantly in groups S,ABS,PAB and PARB T_(2) and T_(3),and the expression of p53 and p21 proteins was significantly reduced in group ABS at T_(2) and in groups S,PAB,and PARB at T_(2) and T_(3) respectively.Compared with T_(2),the percentage of CD34^(+)cells in groups S,ABS,PAB and PARB was significantly increased when the proportion of senescent cells in group PARB was significantly reduced at T_(3),moreover,the p53 protein expression in groups ABS,PAB and PARB and the expression of p21 protein in groups ABS and PAB were significantly increased at

关 键 词：贮存式自体输血 红细胞 造血干细胞 衰老 

分 类 号：R457.1[医药卫生—治疗学]