三种血细胞分离机在单采血小板采集前后的溶血率分析  

Analysis of the hemolysis rate of three blood cell separators before and after plateletpheresis

作　　者：师青泉 莫心南 梁映媚[1] 麦伟珍[1] 郭建生 SHI Qingquan;MO Xin-nan;LIANG Ying-mei(Dongguan Central Blood Station,Dongguan 523930,China)

机构地区：[1]东莞市中心血站,523930 [2]不详

出　　处：《中国现代药物应用》2023年第18期90-93,共4页Chinese Journal of Modern Drug Application

摘　　要：目的比较三种不同型号血细胞分离机在采集后引起的溶血情况,分析和探讨不同单采血小板采集设备及程序造成的溶血差异、原因及对应的解决措施是否能减少溶血的发生。方法选择本站三种不同品牌和型号的血细胞分离机共8台,其中Terumo的Trima共4台,Fresenius Kabi的AmiCORE共3台及Amicus 1台,每台设备各采集健康献血者的血小板10例,共采集健康献血者80例。又单独考虑Trima的血浆还输模式影响,故每台Trima又各采集健康献血者10例,总计研究例数120例。比较三种血细胞分离机采集前后的游离血红蛋白(Hb)水平、Hb阳性率、在相同和不同型号血细胞分离机采集后回血管道游离Hb水平、Trima设备在开启和未开启血浆回输模式下采集后回血管道游离Hb水平和阳性率。结果采集前,游离Hb均为阴性(<0.06 g/L);采集后,在3台AmiCORE和1台Amicus设备的回血管道中测得游离Hb水平均低于标准水平,但在4台Trima设备的回血管道中均测到游离Hb水平高于标准水平。Trima品牌型号的4台仪器回血管道内游离Hb水平比较,差异无统计学意义(P>0.05)。在不考虑献血者个体差异的情况下,Amicus与Trima、AmiCORE与Trima的血细胞分离机回血管道内的游离Hb水平比较,差异有统计学意义(P<0.05)。Trima设备开启血浆回输模式的游离Hb水平为(0.093±0.065)g/L,低于未开启血浆回输模式的(0.157±0.024)g/L,差异有统计学意义(P<0.05)。Trima设备开启血浆回输模式后回血管道游离Hb的阳性检出率下降到40%,明显低于未开启血浆回输模式的100%,差异有统计学意义(P<0.05)。结论使用Trima血细胞分离机进行单采血小板采集,会导致一定程度的红细胞破坏,造成回血管道内溶血。为避免溶血可能对献血者造成的不良影响,对频繁捐献单采血小板的献血者应当尽可能减少使用Trima设备,或使用Trima设备时开启血浆回输模式,有助于减少溶血的发生。Objective To analyze and discuss the differences and reasons of hemolysis caused by different plateletpheresis equipment and procedures and if corresponding solutions can reduce the occurrence of hemolysis through comparing the hemolysis caused by three different blood cell separators.Methods A total of 8 blood cell separators on three different brands and models were selected:4×Trima from Terumo,3×AmiCORE from Fresenius Kabi,and 1×Amicus from Fresenius Kabi.10 plateletpheresis procedures were conducted on each device,and a total of 80 procedures were done.The effect of plasma return mode on Trima was also considered subsequently,then another 10 plateletpheresis procedures were done on each Trima devices.Totally,120 cases were studied.Comparison was made on free hemoglobin(Hb)levels before and after collection and positive rate of free Hb on three blood cell separators,free Hb levels in the blood return tract after collection on the same and different blood cell separators,and free Hb levels and positive rate of free Hb in the blood return tract after collection on the Trima device when plasma return mode was switched on or off.Results Before collection,free Hb was negative(<0.06 g/L).After collection,the free Hb levels in the blood return tracts were lower than the standard level of 3 AmiCORE devices and 1 Amicus device,but higher than the standard level of 4 Trima devices.There was no statistically statistical significance in free Hb levels in the blood return tract of 4 Trima devices(P>0.05).Without considering the individual variation,there was a statistically significant difference in free Hb levels in the blood return tracts between Amicus and Trima devices,AmiCORE and Trima devices(P<0.05).The free Hb level was(0.093±0.065)g/L when plasma return mode of Trima device was switched on,which was lower than that of(0.157±0.024)g/L when plasma return mode was switched off,and the difference was statistically significant(P<0.05).The positive rate of free Hb decreased to 40% when plasma return mode of Trima d

关 键 词：血细胞分离机 单采血小板 溶血率 

分 类 号：R457.1[医药卫生—治疗学]