CAJ | 학술논문

目的掌握去白细胞机采血小板在保存期内的功能变化,为临床输注成分血提供参考依据.方法选择2010年5月至2014年1月于日照市中心血站无偿献血的30例无偿献血者的血样为研究对象.男性献血者为21例,女性为9例;年龄为19～42岁,平均为25.2岁.所有献血者均符合《献血者健康检查要求》(GB18467-2011).所有血液的采集均获得献血者知情同意,并在知情同意一栏签字后献血.通过白细胞过滤方法制备去白细胞机采血小板,于(22±2)℃血小板恒温振荡保存箱中振荡保存,并分别于保存前以及保存后第1,3,5及7天检测去白细胞机采血小板膜表面CD62P(P选择素)的表达率和血栓弹力图(TEG),进而评价随保存时间延长血小板功能的变化情况.结果 ①去白细胞机采血小板保存前白细胞残余量为(5.9±2.1)×105/袋,保存至第5和7天,白细胞残余量相对于保存前明显减少,且差异均有统计学意义(P＜0.05),白细胞残余量随保存时间的延长而减少.②去白细胞机采血小板保存前血小板膜表面CD62P表达率较低,仅为(10.3±2.3)％,保存后第3,5及7天与保存前比较,血小板膜表面CD62P表达率均显著增加,且差异均有统计学意义(P＜0.05),并随保存时间延长,血小板膜表面CD62P表达率逐渐增加.③去白细胞机采血小板保存后第1,3,5及7天R值较保存前显著增加,差异均有统计学意义(P＜0.05),且R值随保存时间延长呈明显增加趋势.而K值和α角在保存期内与保存前比较,差异均无统计学意义(P＞0.05).保存后第5,7天MA值较保存前显著降低,差异均有统计学意义(P＜0.05).结论去白细胞机采血小板在保存期内存在明显的血小板损耗,但对其凝血功能影响不大,保存5d内的去白细胞机采血小板仍是比较理想的成分血.
목적 장악거백세포궤채혈소판재보존기내적공능변화,위림상수주성분혈제공삼고의거.방법 선택2010년5월지2014년1월우일조시중심혈참무상헌혈적30례무상헌혈자적혈양위연구대상.남성헌혈자위21례,녀성위9례;년령위19～42세,평균위25.2세.소유헌혈자균부합《헌혈자건강검사요구》(GB18467-2011).소유혈액적채집균획득헌혈자지정동의,병재지정동의일란첨자후헌혈.통과백세포과려방법제비거백세포궤채혈소판,우(22±2)℃혈소판항온진탕보존상중진탕보존,병분별우보존전이급보존후제1,3,5급7천검측거백세포궤채혈소판막표면CD62P(P선택소)적표체솔화혈전탄력도(TEG),진이평개수보존시간연장혈소판공능적변화정황.결과 ①거백세포궤채혈소판보존전백세포잔여량위(5.9±2.1)×105/대,보존지제5화7천,백세포잔여량상대우보존전명현감소,차차이균유통계학의의(P＜0.05),백세포잔여량수보존시간적연장이감소.②거백세포궤채혈소판보존전혈소판막표면CD62P표체솔교저,부위(10.3±2.3)％,보존후제3,5급7천여보존전비교,혈소판막표면CD62P표체솔균현저증가,차차이균유통계학의의(P＜0.05),병수보존시간연장,혈소판막표면CD62P표체솔축점증가.③거백세포궤채혈소판보존후제1,3,5급7천R치교보존전현저증가,차이균유통계학의의(P＜0.05),차R치수보존시간연장정명현증가추세.이K치화α각재보존기내여보존전비교,차이균무통계학의의(P＞0.05).보존후제5,7천MA치교보존전현저강저,차이균유통계학의의(P＜0.05).결론 거백세포궤채혈소판재보존기내존재명현적혈소판손모,단대기응혈공능영향불대,보존5d내적거백세포궤채혈소판잉시비교이상적성분혈.
Objective To research the function changes of leukocytes reduced apheresis platelets during storage period and to guide the reasonable clinical usage of leukocytes reduced apheresis platelets.Methods From May 2010 to January 2014,a total of 30 cases of blood donors' blood sample in Rizhao Blood Center were included into this study.Male donors were 21 cases and female were 9 cases.Donors'ages were 19 to 42 years old,and average age was 25.2 years old.All donors were confirmed by the "Requirements of Donor Health Examination" (GB18467-2011).Informed consent was obtained from all donors before blood collection.Leukocytes reduced apheresis platelets were prepared through leukocytes filtration method and were preserved at (22 ± 2) ℃ for 7 days.The expression of CD62P and the test of thrombelastogram (TEG) were used to evaluate the function changes of leukocytes reduced apheresis platelets during storage period.Results (①) Before preservation,residual leukocytes of freshly collected platelets were (5.9±2.1) × 105/bag,but it decreased at the first 5 and 7 days of storage compared with before preservation and the differences were statistically different (P＜ 0.05).② Before preservation,CD62P expression of freshly collected platelets only was (10.3 ± 2.3)％.But it increased significantly in the first 3,5 and 7 days of storage compared with before preservation and the differences were statistically different (P＜0.05).③The parameter R value of TEG increased obviously during storage period compared with before preservation,and the differences were statistically different (P＜0.05).While the parameter K value and α angle did not changed obviously during the whole storage period compared with before preservation,and the differences were not statistically different (P＞ 0.05).The parameter MA value decreased significantly in the first 5 and 7 days during storage compared with before preservation and the differences were statistically different (P＜ 0.05).Conclusions The loss of platelets is obvious during storage period,but the coagulation function of leukocytes reduced apheresis platelets is still good in 5 days storage.So leukocytes reduced apheresis platelet within 5 days preservation is still an ideal blood component.