体外模拟加压输血对悬浮红细胞质量影响的研究  

Exploration of Effect on the Quality of Red Blood Cells Suspended during Pressurized Transfusion in Vitro Simulation

作　　者：范瑞 封春雨 王雨婧 尚玮玮 唐文飞 马海梅 张欢[2,3,4] FAN Rui;FENG Chunyu;WANG Yujing;SHANG Weiwei;TANG Wenfei;MA Haimei;ZHANG Huan(Department of Blood Transfusion,Beijing Tsinghua Changgung Hospital;Department of Anesthesiology,Beijing Tsinghua Changgung Hospital;Institute for Precision Medicine,Tsinghua University;School of Clinical Medicine,Tsinghua University Beijing 102218)

机构地区：[1]清华大学附属北京清华长庚医院输血科 [2]清华大学附属北京清华长庚医院麻醉科 [3]清华大学精准医学研究院 [4]清华大学临床医学院,北京102218

出　　处：《临床输血与检验》2024年第2期223-229,共7页Journal of Clinical Transfusion and Laboratory Medicine

基　　金：清华大学精准医学科研项目(No.20229990039)资助。

摘　　要：目的探讨不同压力对悬浮红细胞质量的影响,为研制加压输血装置提供数据支撑。方法将25袋悬浮红细胞随机等分成5组,分别施加10、20、30、40和50 Kpa压力,实时记录血流速度;施压前后分别留取部分血样测定红细胞相关指标(RBC、HGB、HCT、MCV、MCH、MCHC)变化情况,测定血浆中钾离子、间接胆红素、乳酸脱氢酶、游离血红蛋白含量;检测红细胞渗透脆性并用电镜观察红细胞形态变化,从而评价不同压力对血液质量的影响。结果加压可显著提高输血速度。在不同压力下红细胞相关指标变化与K+、IBIL、LDH变化无统计学意义,游离血红蛋白与溶血率均符合国家有关规定。电镜下观察随着压力升高出现少量异形红细胞,胞膜电子密度有差异,网状结构破坏,网眼不均匀。结论在50 Kpa范围内加压对红细胞损伤影响不大,血液质量符合我国相关标准要求。Objective To explore how various pressures affect the quality of red blood cells in suspension,and to offer data assistance for the creation of pressurized blood transfusion apparatus.Methods Five groups were randomly selected from the 25 bags of suspended erythrocytes,and pressures of 10,20,30,40,and 50 Kpa were applied to each group respectively.The blood flow rate was recorded in real time.Before and after the pressure application,blood samples were obtained to look for changes in erythrocyte-related indices(RBC,HGB,HCT,MCV,MCH,MCHC).The content of potassium ion,indirect bilirubin,lactate dehydrogenase,and free haemoglobin in plasma were detected.The osmotic fragility was tested,and the morphology was observed.Finally,the effects of different pressures on blood quality were evaluated.Results The transfusion rate can be considerably raised by pressurization.The alterations in K+,IBIL,and LDH indices as well as erythrocyte-related indexes under various pressures did not show statistically significant changes.Free haemoglobin and haemolysis rate were in accordance with the national regulations.Certain heterogeneous erythrocytes with rising pressure,variations in the cytomembrane's electron density,disruption of the reticulum's structure,and reticulum inhomogeneity were seen using electron microscopy.Conclusion The brief duration pressure,within the range of 50 Kpa,does not significantly result in red blood cell destruction,and the blood quality can meet Chinese norms.

关 键 词：加压输血 红细胞 血液质量 

分 类 号：R457[医药卫生—治疗学]