国际输血及血液学杂志
國際輸血及血液學雜誌
국제수혈급혈액학잡지
INTERNATIONAL JOURNAL OF BLOOD TRANSFUSION AND HEMATOLOGY
2013年
3期
213-216
,共4页
全血%成分血%内毒素检测%安全控制
全血%成分血%內毒素檢測%安全控製
전혈%성분혈%내독소검측%안전공제
whole blood%blood components%endotoxin detection%safety control
目的 通过对全血、成分血内毒素动态监测和细菌培养,评估内毒素水平与细菌培养结果的吻合性；临床输血发热反应与血液内毒素关联性；评价血液细菌及内毒素安全控制机制的有效性.方法 选择2009年3月至4月本中心的志愿献血者血液样本300份为研究对象,按样本品种分为3组:全血组(n=50)、悬浮红细胞(RBC)成分血组(n=150)及血小板(PLT)成分血组(n=100)；并选择2009年1月至2月于街头无偿献血的健康志愿者全血样本361份作为对照组,并以对照组内毒素检测结果作为正常人群参考范围.采用动态浊度法内毒素定量检测技术,分别对各组血液保存前、中、后期血液样品进行内毒素含量检测,采用方差分析比较各组血样在不同保存时间段内毒素变化情况,并结合其细菌培养结果进行分析；同时检测临床输血发热反应血样的内毒素水平.结果 正常人群血液内毒素参考值为(0～0.193) EU/mL;PLT悬液组与对照组(W=0.635,P=0.0585)与悬浮RBC组与对照组(W=0.334,P=0.583)血样在前、中、后3个时间段的内毒素含量比较,差异均无统计学意义；全血组内毒素含量保存前期与后期、中期与后期之间比较,差异有统计学意义(W=0.860,P=0.014),全血、成分血内毒素水平为(0.005～0.188) EU/mL,细菌培养结果均为阴性；发生输血发热反应的样本血液内毒素监测水平为(0.023～0.145)EU/mL.结论 当全血、成分血细菌培养呈阴性时,其内毒素水平比较均无异常,显示彼此结果吻合；输血发热反应血样的内毒素水平正常,提示与输血发热反应无关联性.现行采供血机构在医用耗材、献血者筛查、血液采集、制备、保存、运输等环节,对血液细菌及内毒素安全控制机制是有效的.
目的 通過對全血、成分血內毒素動態鑑測和細菌培養,評估內毒素水平與細菌培養結果的吻閤性；臨床輸血髮熱反應與血液內毒素關聯性；評價血液細菌及內毒素安全控製機製的有效性.方法 選擇2009年3月至4月本中心的誌願獻血者血液樣本300份為研究對象,按樣本品種分為3組:全血組(n=50)、懸浮紅細胞(RBC)成分血組(n=150)及血小闆(PLT)成分血組(n=100)；併選擇2009年1月至2月于街頭無償獻血的健康誌願者全血樣本361份作為對照組,併以對照組內毒素檢測結果作為正常人群參攷範圍.採用動態濁度法內毒素定量檢測技術,分彆對各組血液保存前、中、後期血液樣品進行內毒素含量檢測,採用方差分析比較各組血樣在不同保存時間段內毒素變化情況,併結閤其細菌培養結果進行分析；同時檢測臨床輸血髮熱反應血樣的內毒素水平.結果 正常人群血液內毒素參攷值為(0～0.193) EU/mL;PLT懸液組與對照組(W=0.635,P=0.0585)與懸浮RBC組與對照組(W=0.334,P=0.583)血樣在前、中、後3箇時間段的內毒素含量比較,差異均無統計學意義；全血組內毒素含量保存前期與後期、中期與後期之間比較,差異有統計學意義(W=0.860,P=0.014),全血、成分血內毒素水平為(0.005～0.188) EU/mL,細菌培養結果均為陰性；髮生輸血髮熱反應的樣本血液內毒素鑑測水平為(0.023～0.145)EU/mL.結論 噹全血、成分血細菌培養呈陰性時,其內毒素水平比較均無異常,顯示彼此結果吻閤；輸血髮熱反應血樣的內毒素水平正常,提示與輸血髮熱反應無關聯性.現行採供血機構在醫用耗材、獻血者篩查、血液採集、製備、保存、運輸等環節,對血液細菌及內毒素安全控製機製是有效的.
목적 통과대전혈、성분혈내독소동태감측화세균배양,평고내독소수평여세균배양결과적문합성；림상수혈발열반응여혈액내독소관련성；평개혈액세균급내독소안전공제궤제적유효성.방법 선택2009년3월지4월본중심적지원헌혈자혈액양본300빈위연구대상,안양본품충분위3조:전혈조(n=50)、현부홍세포(RBC)성분혈조(n=150)급혈소판(PLT)성분혈조(n=100)；병선택2009년1월지2월우가두무상헌혈적건강지원자전혈양본361빈작위대조조,병이대조조내독소검측결과작위정상인군삼고범위.채용동태탁도법내독소정량검측기술,분별대각조혈액보존전、중、후기혈액양품진행내독소함량검측,채용방차분석비교각조혈양재불동보존시간단내독소변화정황,병결합기세균배양결과진행분석；동시검측림상수혈발열반응혈양적내독소수평.결과 정상인군혈액내독소삼고치위(0～0.193) EU/mL;PLT현액조여대조조(W=0.635,P=0.0585)여현부RBC조여대조조(W=0.334,P=0.583)혈양재전、중、후3개시간단적내독소함량비교,차이균무통계학의의；전혈조내독소함량보존전기여후기、중기여후기지간비교,차이유통계학의의(W=0.860,P=0.014),전혈、성분혈내독소수평위(0.005～0.188) EU/mL,세균배양결과균위음성；발생수혈발열반응적양본혈액내독소감측수평위(0.023～0.145)EU/mL.결론 당전혈、성분혈세균배양정음성시,기내독소수평비교균무이상,현시피차결과문합；수혈발열반응혈양적내독소수평정상,제시여수혈발열반응무관련성.현행채공혈궤구재의용모재、헌혈자사사、혈액채집、제비、보존、운수등배절,대혈액세균급내독소안전공제궤제시유효적.
Objective Through dynamic monitoring bacterial endotoxin and cultivating whole blood and blood components,consistence between endotoxin level and bacterial culture results,association between the clinic fever reaction and blood endotoxin were evaluated.Furthermore,the effectiveness of safety control mechanism on bacterium and endotoxin was assessed.Methods From March to April 2009,a total of 300 blood samples of volunteer donors from our blood center were included in this study.Based on the sample varieties,all of these samples were divided into 3 groups:the whole blood group (n=50),suspended red blood cell (RBC) components group (n=150) and platelet (PLT) components group (n=100).Meanwhile 361 healthy donors from the street during January to February 2009,were chosen as a control group,and their endotoxin results would be used as normal reference range.Dynamic turbidity was used as the quantitative detection method of bacterial endotoxin.Endotoxin content in each group was individually detected during their blood preservations.And the endotoxin content results of each group in different blood preservation period and their bacterial cultivating results were analyzed by variance of repeated measurement data.Moreover,the samples from clinical transfusion fever reaction were detected for endotoxin level.Results Normal blood endotoxin reference range from the control group was (0-0.193) EU/mL.PLT suspension group (W=0.635,P =0.0585),and suspended RBC group (W =0.334,P =0.583) had no significant differences in endotoxin concentration of three periods.There were significant differences in endotoxin in whole blood group of three periods (W=0.860,P=0.014).The endotoxin level of whole blood and blood components was (0.005-0.188) EU/mL,and all bacterial cultivating results were negative.Endotoxin concentration in blood samples of transfusion fever reaction was (0.023-0.145) EU/mL.Conclusions While cultivating results of whole blood and blood components were negative,their endotoxin levels were normal and endotoxin level and bacterial culture results were consistent.Normal endotoxin concentration in blood samples of fever reaction announced no association with transfusion fever reaction.It could be shown that these procedures including medical consumed material,blood donor screening,blood collection,preparation,preservation,transportation,etc,are effective for the safety control mechanism of blood bacterial and endotoxin in current blood transfusion services.
