自制输血相容性检测室内质控品保存条件的研究

Inside Quality Control for Whole Blood Preservation Performed at Blood Transfusion Compatibility Testing Laboratory

本研究目的是利用输血相容性检测实验室现有血液标本资源,建立自制室内质控品技术。随机选取24名A型RhD阳性的健康献血者,分别采集静脉血4ml,采用析因设计方法,根据使用抗凝剂种类、是否添加红细胞保存液以及标本每日室温存放时间,将24个标本随机平均分成8组,将所有盛装标本的试管盖帽后4℃保存,每天在室温放置l小时或2小时。分别在保存的0、7、14、21、28、35天测定所有标本的ABO、RhD血型(记录正反定型的凝集强度)、IgM抗B抗体效价和上清液中游离血红蛋白浓度并计算其增量值。结果表明:使用ACD.B抗凝剂并添加MAP红细胞保存液,每天室温放置1小时(A282C1)组标本的红细胞损伤最小,各时间点FHb浓度及其增量值均最低(P<0.01),35天时FHb浓度仅为(245.1±84.5)mg/L。保存过程中A抗原、D抗原及IgM抗B抗体反应活性无明显变化(P>0.05)。结论:在输血相容性检测实验室现有条件下,可以利用本研究建立的A282C1方案制备出性能相对稳定、可有效保存的能够满足室内质控要求的改良全血室内质控品。

This study was aimed to establish the technique for preparation and storage of internal quality control products by using existing blood sample resources of blood transfusion compatibility testing laboratory. 24 healthy blood donors with group A and RhD-positive were randomly selected, and 4 ml venous blood from these donors were collected, respectively. Based on the use of anticoagulant type ,whether to add red blood cell preservation solution and the samples stored at room temperature for 1 or 2 hours daily,24 specimens were randomly divided into 8 groups by using factorial design methodology. All samples in tube with cap were stored at 4 ~C, and placed at room temperature for 1 or 2 hours daily. ABO, RhD blood group （recorded on the agglutination strength of the forward and reverse typing）, lgM anti-B antibody titer, and free hemoglobin concentration in the supernatant for all samples were detected at 0,7,14,21,28,35 days of products preservation. The results indicated that the red blood cell damage from the group used anticoagulants ACD-B and added the MAP red blood cell preservation solution and placed at room temperature 1 hour daily （recorded as A2B2C1 group） was kept minimal, and FHb concentration and FHb increments at each time point were the lowest （p 〈 0.01 ）, the FHb concentration on 35th day was only （ 24.5 ± 84.5 ） mg/L. There was no significant change of A anti gen, D antigen and IgM anti-B antibody response activity and stability in A2B2C1 group during storage for 35 days （p 〉 0.05）. In conclusion, blood transfusion compatibility testing laboratory can use A2B2C1 program established by this study to prepare relatively stable modified whole blood internal quality control products in the existing conditions, which can be effectively preserved and meet the requirements of internal quality control for blood transfusion compatibility testing.