添加剂红细胞悬液保存期间炎性细胞因子水平动态观察

Dynamic Study of Proinflammatory Cytokine Levels in Preservative Red Cells during Storage

目的 观察添加剂红细胞悬液 (PRC)保存期间白细胞介素 (IL) 1 β、IL 6、IL 8和肿瘤坏死因子 (TNF) α水平变化 ,探讨非溶血性发热反应 (FNHTR)可能发生的机制 ;观察滤除白细胞对上述细胞因子水平的影响 ,为选择滤除白细胞时间提供依据。方法 1 0U添加剂红细胞各分为 2等份 ,其中 1份滤除白细胞 ,分别于 0周和 1 ,3 ,5周末采用ELISA法测定IL 1 β、IL 6、IL 8和TNF α水平。 结果 新鲜PRC中IL 1 β、IL 6、IL 8和TNF α含量较低 ,随保存时间延长增高 ,尤以 3周后明显 ;保存前滤除白细胞后PRC保存期间IL 1 β、IL 6、IL 8和TNFα水平无明显升高 ;保存期末 4种炎性细胞因子水平与保存前WBC数量间呈正相关。结论 未去除白细胞的PRC在保存期间能够自发产生和积聚IL 1 β、IL 6、IL 8和TNF α ,部分FNHTR的发生可能与此有关 ;

Objective In order to explore the mechanism of febrile non hemolytic transfusion reactions(FNHTRs),levels of interleukin(IL) 1β,IL 6,IL 8,and tumor necrosis factor(TNF)α in preservative red cells(PRCs) during storage were studied.Effect of leukocyte filtration on the cytokine levels was also observed for the purpose of selecting filtration time.Methods Each of 10 units of PRC were divided into 2 equal bags.One bag was filtrated with leukocyte reducing filtrator.Each of 10 of IL 1β,IL 6,IL 8,and TNFα in 20 PRCs were determined by enzyme linked immunosorbent assay(ELISA)at colleetion at the end of 1st,3rd and fifth weak of storage.Results Concentrations of IL 1β,IL 6,IL 8,and TNFα in PRCs were very low on the day of collection and tended to increase after storage.After prestorage leukoredu ction,however,the concentration of these cytokines showed no significant increase.The levels of the cytokines correlated positively with WBC before storage. Conclusion Proinflammatory cytokines generate and accumulate spontaneously in PRCs during storage.which may be associated with FNHTRs.All of these may be prevented by leukoreduction.