器官保存液中聚乙二醇对人红细胞聚集性和血液流变学的影响

Effects of polyethylene glycol on human red blood cell aggregation and hemorheology in preservation solution

背景:聚乙二醇作为一种非渗透性大分子物质,在器官保存液中可发挥保护细胞膜、维护细胞骨架完整性、防止细胞水肿、抗脂质过氧化和免疫调节的作用。目的:探讨器官保存液中的聚乙二醇对人红细胞聚集性和血液流变学的影响。设计、时间及地点:对比观察实验,于2008-10在解放军第二军医大学附属长征医院器官移植科完成。材料:抽取接受体格检查的6名健康志愿者的肘前静脉血。方法:在抽取的新鲜血液中按5:1的稀释比分别加入生理盐水、器官保存液及含不同相对分子质量、不同浓度聚乙二醇的多器官保存液,按加入液体的不同分为:生理盐水组、器官保存液组、不添加聚乙二醇的保存液组、20聚乙二醇1,10,30g/L和35聚乙二醇1,10,30g/L组。主要观察指标:室温下通过魏氏法检测红细胞沉降率、自动血液流变仪检测血液流变学指标、光镜观察红细胞聚集的形态学改变,分析聚乙二醇对人红细胞聚集性和血液流变学的影响。结果:不含胶体的保存液对红细胞聚集无影响,含低浓度聚乙二醇的保存液对红细胞聚集性和血液流变学的影响较小,器官保存液组、20聚乙二醇30g/L,35聚乙二醇10g/L和35聚乙二醇30g/L的保存液则可显著加快红细胞沉降率,降低红细胞变形能力,引起红细胞明显聚集。结论:器官保存液中的聚乙二醇可引起红细胞聚集,降低红细胞变形能力,其相对分子质量越大,浓度越高,促进红细胞聚集的作用越明显,对血液流变学的影响越大。

BACKGROUND： Polyethylene glycol （PEG）, as an impermeable macromolecule, plays roles in protecting molecular membrane, maintaining the integrity of cytoskeleton, preventing edema of cell, and immune regulation in preservation solution. OBJECTIVE： To investigate the effects of PEG on human red blood cell aggregation and hemorheology in preservation solution. DESIGN, TIME AND SETTING： A control observational experiment was performed in Department of Organ Transplantation, Changzheng Hospital Affiliated to the Second Military Medical University in October 2008. MATERIALS： Venous blood was drawn from the anterior forearm of six healthy volunteers. METHODS： Venous blood was mixed with normal saline, University of Wisconsin （UW） solution, SMO （Shanghai multi-organ） solution with different relative molecular mass and different concentration of PEG. The dilution ratio of blood with preservation solution was 5：1. According to the different solution added to blood, blood samples were divided into nine groups： normal saline, UW solution, SMO solution without PEG, with 1 g/L PEG-20, 10 g/L PEG-20, 30 g/L PEG-20, 1 g/L PEG-35, 10 g/L PEG-35 and 30 g/L PEG-35. MAIN OUTCOME MEASURES： Erythrocyte sedimentation rate was measured by Westergren method at room temperature. Hemorheology parameters were evaluated by using an automatic hemorheological analyzer. Changes in morphology of red blood cells were evaluated by light microscopy. Effects of PEG on human red blood cell aggregation and hemorheology were analyzed. RESULTS： The aggregation of red blood cell was not affected by the solution without colloid. Preservation solution with low concentration PEG had little effect on red blood cell aggregation and hemorheology. The erythrocyte sedimentation rates were significantly increased and the deformability of red blood cells were decreased in the UW solution, SMO solution with 30 g/L PEG-20, 10 g/L PEG-35 and 30 g/L PEG-35 groups, which induced a hyperaggregating effect on red blood cell. CONCLUSION： PEG in UW solution can induce red blood cell aggregation increased and red blood cell deformability decreased As the relative molecular mass and concentration increasing, the effects on inducing red blood cell aggregation and hemorheology are more obvious.