不同预充液对处于机械应力下的红细胞的保护作用

Protective Effects of Priming Solutions on Erythrocytes Exposed to Mechanical Stress

目的比较红细胞处于不同预充液中,受到相同程度机械应力作用时的溶血情况。方法10个单位浓缩红细胞(200 m l),每袋均分为4份,各50 m l,分别加入50 m l乳酸钠林格氏液(L组)、5%人血白蛋白(A组)、4%琥珀酰明胶注射液(G组)和6%羟乙基淀粉注射液(H组)。混匀后,将其预充于以滚压泵驱动的循环装置上,以1 L/m in的流量室温下循环4 h。分别于循环开始时、1 h、2 h、3 h、4 h取血标本2 m l,离心后取上清液,测定游离血红蛋白(Free Hb)和乳酸脱氢酶(LDH)水平,于循环开始和结束时取血标本测定血气、血红蛋白浓度和乳酸脱氢酶(LDH)。红细胞形态学变化采用伊红染色后光镜下观察。结果4组游离血红蛋白和乳酸脱氢酶水平循环后各时点均较基础值有不同程度升高,差异有显著性(p<0.05)。循环后各时点A组和G组游离血红蛋白和乳酸脱氢酶水平均较其他两组低,4 h差异有显著性(p<0.05)。红细胞形态在A组和G组维持较好。结论受到机械应力时,人血白蛋白和琥珀酰明胶对红细胞的保护作用较好。

OBJECTIVE To investigate the protective effects of priming solutions on erythrocytes exposed to mechanical stress. METHODS Free haemoglobin and LDH release from packed red blood cells in 4% fluid succinylated gelatin, 5% albumin solution, 6% hydroxyethyl starch and Sodium Lactate Ringer＇s Injection was investigated in vitro during circulation with a roller pump from a heart - lung machine for 4 hours at a flow rate of 1.0 L/min at room temperature. RESULTS Erythrocyte osmotic fragility was similar among all groups. Free haemoglobin and LDH concentrations became progressively higher in every group. 4% fluid succinylated gelatin appears to have potent erythrocyte protective properties similar to those of albumin. CONCLUSION This effect could decrease mechanical haemolysis during extracorporeal circulation if modified fluid gelatin or albumin solution is used as part of a priming solution.