γ射线辐照单采血小板功能及临床应用研究

Study of the function and clinical application in gamma irradiated apheresis platelet

目的研究不同剂量辐照灭活淋巴细胞及对血小板活性的影响并观察γ射线辐照单采血小板临床应用效果。方法将单采血小板分装于5个血袋中,分别作为未辐照组(对照组)和25、30、35、40Gy不同剂量辐照组,将上述经辐照前后的血小板标本经淋巴细胞分离液分离出淋巴细胞后,用植物血凝素(PHA)刺激T淋巴细胞,使其转化为淋巴母细胞,经瑞氏染色后用显微镜分别计数转化为母细胞的百分率;用流式细胞仪检测经35Gy剂量辐照后的血小板的CD41a、CD62p;选取40例接受化疗的急性白血病患者,随机分为对照组和治疗组,其中对照组20例,治疗组20例,分别输单采血小板和辐照单采血小板,观察血小板纠正增加指数(CCI)及输注后临床表现。结果剂量为35Gy时,淋巴细胞的转化率为0;35Gyγ射线辐照前后血小板CD41a、CD62p阳性率的比较差异无统计学意义(P>0.05);治疗组和对照组血小板输注有效率的比较差异无统计学意义(P>0.05)。结论适当剂量的辐照可以有效减少血液中有活性淋巴细胞的数量,同时又对血小板的活性没有显著的损伤。

Objective To study the influence of the activity of platelet by different dose of irradiation,and to evaluate the function and clinical application of gamma irradiated apheresis platelets.Methods Apheresis platelets were divided into 5 parts.Then the divided platelets were divided into control group and test group which accepted 25 Gy,30 Gy,35 Gy and 40 Gy.The lymphocytes were separated from irradiated platelets and T lymphocytes were transformed into lymphoblast stimulated by PHA,then the percent of lymphoblast was calculated by microscope after exposed to Wright strain,CD41a and CD62p of 35 Gy irradiated platelets were examined by flowcytometry.40 acute leukemia patients were divided into control group and test group,with 20 cases in each group,they were transfused apheresis platelets and irraditiated apheresis platelets,then CCI and clinical manifestation were observed.Results The percent of lymphoblast was 0 of 35 Gy irraditiated platelets and there was no significant difference of the positive rate of CD41a and CD62p before and after irradiation（P〈0.05）.There was no significant difference of the efficiency of platelet transfusion between test group and control one（P〈0.05）.Conclusion Appropriate dose can decrease the activity of lymphocytes but don′t impaired the activity of platelets.