保存前滤除白细胞对红细胞保存质量的研究分析

Research and analysis Of red blood cells quality by filtering leucocytes before preservation

目的探讨保存前滤除白细胞对不同保存时期红细胞的质量影响。方法随机采集10名志愿健康献血者全血400×10袋,常规分离血浆制备成悬浮红细胞2μ×10袋。根据配对设计方法,将血液等量分成两份1μ×20袋,其中10袋在2～4℃静置2～4h后用一次性去白细胞滤器滤除白细胞制备少白细胞红细胞(LPRC)为滤过组,另10袋不做其它处理直接保存悬浮红细胞(CRCs)为对照组。在两组相同保存期0、7、14、21、28、35d分别测定:1)红细胞平均体积MCV、红细胞分布宽度RD-WR;2)保存期红细胞形态观察;3)红细胞ATP水平;4)悬浮红细胞上清液检测钾离子K+、乳酸脱氢酶LDH。结果两组MCV,RDWR随保存时间延长未见明显改变P>0.05。两组红细胞ATP水平随保存期延长逐渐下降无显著差异P>0.05,保存35d时两组红细胞ATP水平下降至0.92mmol/L、0.97mmol/L以下,同时镜下观察到对照组有10%左右、滤过组5%左右红细胞棘状样变,但未见畸形红细胞。对照组和滤过组K+随保存时间延长逐渐增加,对照组增加速度略高于过滤组,至保存期14d两组差异有统计意义P<0.05。与滤过组相比对照组LDH增加速度明显高于滤过组,除0d外其他保存期两组差异均有统计意义P<0.01。结论过滤组可见LDH水平明显抑制,K+增加速度相对较缓。两组红细胞ATP水平随保存期延长逐渐下降,并出现数量和程度不等的红细胞棘状样改变,提示保存前去除白细胞可能更有利于红细胞保存。

Objective To study the effect on quality of red blood cells suspension by filtering white cell during different preservation. Methods 10 healthy donators were collected, whole blood 400ml× 10 bags, and made them into red blood cells suspension （CRCs）1 unite× 10 bags as contrast group and leucocyte-poor red cells （LPRC） 1 unite× 10 bags as filter group. Then were analyzed respectively.. 1. mean corpuscular volume （MCV）, red blood cell volume distribution width （RDWR）, 2. Red blood cell shape, 3. Red blood cell ATP, 4. K＋, LDH in blood bags during 0, 7,14,21, 28, 35 days. Results In two groups, MCV and RDWR were not changed significantly with the prolongation of preserving time. In two groups, ATP in red blood cell was gradually decreasing with the prolongation of preservation time （P 〉 0.05）. and when CRCs, LPRC was preserved for 35 days, ATP in red blood cell was decreased 0. 92 mmol/L - 0. 97mmol/L. Spines form red blood cells were observed under microscope in contort group about 10% and about 5% in filtration group respectively. But the change in control group was more serious than in filtration group. And others were not freakish. K＋ was gradually increasing and after 14 days, k＋ in contrast group was higher than in filter group （P 〈 0.05）. LDH in contrast group was significantly higher than in filter group during preservation of CRCs （P 〈 0.01）. Conclusions LDH in filter group was restrained obviously, and k＋ increased slowly. ATP in red blood cells decreased gradually in two groups and the qualities and degree of spines form red blood cell are greatly different in two groups. So it＇s better to filter leucocytes before preserving red blood cells.