全血及成分血内毒素动态监测

Dynamic Monitoring on the Bacterial Endotoxin Concentration in Whole Blood and Blood Component

目的通过监测全血及成分血的内毒素含量动态变化，探讨内毒素监控的意义，为评估血液安全提供依据，保证安全输血。方法选择2009年3月至4月本血液中心献血者中，符合国家《献血者健康检查要求》的自愿献血者血液样品300份为研究对象。按血液成分分为3组：全血组（n=50）、悬浮RBC成分血组（n=150）及PLT成分血组（n=100）。采用动态浊度法内毒素定量检测技术分别于各组血液保存前期、中期及后期检测各个血液样品内毒素含量，并采用方差分析比较各个检测时间点血样内毒素变化情况。结果全血保存期前中后期中，内毒素含量在部分时段差异有统计学意义（W=0．860，P〈O．05）；而PLT悬液、悬浮RBC在3个时间段的内毒素含量差异无统计学意义（P〉0．05）。结论对全血及成分血的内毒素含量监测，结果显示血液保存期的内毒素含量稳定与其细菌培养阴性相吻合，表明现行的采供血流程的质量控制是有效的，可有效保障血液的安全。

Objective To explore the importance of dynamic monitoring on the bacterial endotoxin and assess the blood safety to guarantee the safety of blood transfusion, through dynamically monitoring the bacterial endotoxin concentration in whole blood and blood component. Methods From March to April 2009, 300 donors＇ samples, which had met the requirements of donors＇ health check, were included in this study. According to the blood component, all these samples were performed into three groups： whole blood group （n=50）, red blood cells （RBC） suspension group （n=150）, platelet （PLT） components group （n= 100）. Dynamic turbidity in blood which were respectively stored at early stage, metaphase and later stage, were used as the detection quantitative method of bacterial endotoxin. And the results were further analyzed by variance of repeated measurement data. Results There was no difference of the bacterial endotoxin concentration during the preservation in PLT suspension and RBC suspension（P〉0.05）. Meanwhile, there was significant difference of the bacterial endotoxin concentration between preservation periods of the whole blood（P〈0. 05）. Conclusions Through dynamically monitoring the bacterial endotoxin concentration in whole blood and blood component, the stability of bacterial endotoxin concentration during the preservation period coincides with a negative result of the bacterial culture. It could be shown that the quality control of the blood collection and supply procedure is effective to guarantee the safety of blood.