不同保存时间的库存红细胞携氧能力变化研究

Oxygen-carrying capacity of suspension red blood cells in the preservation process

目的建立红细胞携氧能力相关评价指标与库存时间的数学模型,为红细胞定量输注提供实验依据。方法随机选取6名合格献血者,采集红细胞1 U/人(全血200 mL=1 U)制备成悬浮红细胞,置于专用储血冰箱,分别在库存0、7、14、21、28和35 d留取血样,测定有效携氧量(Q值)、氧亲和力(P50)、2,3-DPG、Na+-K+-ATP酶,综合评价红细胞携氧能力;应用统计学软件对数据进行曲线拟合分析,获得计算各携氧能力指标与库存时间的数学模型。结果在保存期内的红细胞Q值随库存时间的增加而逐渐下降:库存14 d前下降较快,至14 d下降了32%,之后下降变缓,到保存末期仅为库存0 d红细胞的49%;P50随库存时间的增加而逐渐下降:库存14 d前下降较快,至14 d下降了19%,之后下降不明显,到保存末期为库存0 d红细胞的71%;2,3-DPG随库存时间的增加而逐渐下降:库存21 d前缓慢下降,之后出现急速下降,到储存期末仅为库存0 d红细胞的41%;Na+-K+-ATP酶随库存时间的增加而逐渐下降:库存前7 d下降最为剧烈,下降54%,之后下降速度变缓,到储存期末仅为库存0 d红细胞的15%;对数据曲线的拟合分析显示:以Q值为因变量Y,库存时间为自变量X,得出回归方程为Y=4.367-0.066X;以P50为因变量Y,库存时间为自变量X,得出Y=28.346-0.234X;以2,3-DPG为因变量Y,库存时间为自变量X,得出Y=1.875-0.030X;以Na+-K+-ATP酶为因变量Y,库存时间为自变量X,得出为Y=4.534-0.127X。Q值和P50完全线性相关(r=0.999 43),与库存时间、2,3-DPG、Na+-K+-ATP酶存在回归关系,其多元线性模型为Q=5.457-0.925×2,3-DPG+0.142×Na+-K+-ATP酶-0.076×T(库存天数)。结论 Q值测定水平可以作为库存红细胞携氧能力评价的重要指标,并可根据其变化计算不同库存时间红细胞的携氧能力。红细胞随库存时间的延长其携氧能力不断下降,库存前2周其携氧能力下降的尤为明显,贮存35 d的红细胞携氧能力仅为0 d的50%。

Objective To measure the oxygen-carrying capacity of suspension red blood cells in the preservation process,so as to establish mathematical model of parameter of erythrocyte oxygen-carrying evaluation with the saving time and provide experimental evidence for quantitative erythrocyte infusion.Methods Harvested 1 unit of red blood cells（200 mL / unit） per person from 6 blood donors who met the conditions of national blood donation,prepared into suspension red blood cells,placed in professional refrigerator.Detected effective oxygen-carrying amount（Q value）,P50,2,3-DPG,Na ＋-K ＋-ATPase in the different time point of stock 0,7,14,21,28 and 35 days to comprehensively evaluate oxygen-carrying capacity of red cells.Data was analyzed with SAS 8.2（TS2M0） statistical software.Various indicators and stock time were calculated to elucidate the internal relations by curve fitting analysis.Results The Q value decreased with the preservation time.It decreased faster before 14th day with a decrease of 32%,while slower after that.At the end of preservation,the Q value of PRBCs was only 49% of PRBCs in 0 day.The P50 values decreased in the preservation period.It decreased faster before 14th day with a decrease of 19% while relatively stable after that.At the end of preservation,the P50 values of PRBCs was 71% of PRBCs in 0 day.2,3-DPG decreased with the preservation time.It decreased slower before 21st day while dramatically descended after that.At the end of preservation,2,3-DPG of PRBCs was only 41% of PRBCs in 0 day.Na ＋-K ＋-ATP enzyme also decreased with the preservation time.It decreased severely in the first week with a decrease of 54%,while slower after that.At the end of preservation,Na ＋-K ＋-ATP enzyme of PRBCs was only 15% of PRBCs in 0 day.The various indicators of effective oxygen-carrying capacity linear correlated with stock time by curve fitting analysis.The regression equation was Y = 4.367-0.066X with Q value as dependent variable Y,stock time as independent variable X;the regression equation was Y = 28.346-0.234X with P50 as dependent variable Y,stock time as independent variable X;the regression equation was Y = 1.875-0.030X with 2,3-DPG as dependent variable Y,stock time as independent variable X;the regression equation was Y = 4.534-0.127X with Na ＋-K ＋-ATPase as dependent variable Y,inventory time as independent variable X;Q value and P50 had completely linear correlation（r = 0.99943）;the regression correlation existed in Q value,2,3-DPG,stock time,Na ＋ K ＋-ATPase enzyme,the equation was Q = 5.457-0.925 × 2,3-DPG ＋ 0.142 × Na ＋-K ＋-ATPase-0.076 × T（stock days）.Conclusion Q value in vitro could be described and evaluated as an important indicator of the stock erythrocyte oxygen-carrying capacity that can be calculated according to Q value change.Erythrocyte oxygen-carrying capacity reduced with the stock time extension.It dramatically declined before 2 weeks preservation.It decreased by 50% at the end of preservation compared with the beginning of preservation.