去除白细胞对库存血流变学特性的影响

Effects of leukocyte removement on the hemorheologic properties of the preserved blood in bank

目的 观察去除白细胞后库存血流变特性的变化。方法 选择６０例健康献血员，随机分为Ａ、Ｂ两组，Ａ组为去白细胞组，Ｂ组为对照组。应用去白细胞输血滤过器去除白细胞，常规保存，取新鲜血（采集后１ｈ）、１周、２周及３周４个时相点。进行白细胞、红细胞计数及全血高切粘度、中切粘度、血浆粘度、血球压积及红细胞聚集指数（ＡＩ）和刚性指数（ＩＲ）检测。结果 滤过后白细胞显著减少（Ｐ＜０．０１）。在３周保存时间内，白细胞、红细胞计数、血球压积无显著变化，两组高切粘度在第３周显著升高，而低切粘度下降。血浆粘度、ＡＩ和ＩＲ随保存时间延长进行性下降。两组间比较在第３周ＡＩ存在显著差异（Ｐ＜０．０５）。结论 滤过能有效降低血液中的白细胞。去除白细胞库存血可能有利于保护红细胞的聚集性，对血液粘度及红细胞变形性无显著影响。

Objective To observe the changes of the hemo-rheologic properties in the blood with leukocyte removement during storage. Methods Sixty cases of healthy donors were divided randomly into two groups, leukocyte removement group (A) and control group (B). Leukocyte-filter were used to remove the leukocyte from the blood before storage. The blood was preserved as usual. The number of leukocyte, red blood cell and whole blood viscosity(WBV) under high, middle and low shear rate, plasma viscosity, hematocrit, red blood cell aggregation index(AI) and index of rigidity(IR) were measured at 1hour, 1 week, 2 weeks and 3 weeks of storage. Results The number of leukocyte descreased significantly after filtration(P < 0. 01 ). The number of leukocyte, red blood cell and the hematocrit did not change significantly within 3 weeks. WBV under high shear rate increased while WBV under low shear rate decreased significantly at 3 weeks. The plasma viscosity, AI and RI dereased progressively as the time of preservation went by in two groups. There was significant difference of AI between two groups(P < 0. 05) at 3 weeks. Conclusion The filtration can reduce effectively the number of leukocyte. Leukocyte-removement is probably efficient for reserving the aggregation of red blood cell during storage and does not significantly affect the blood viscosity and deformability of red blood cell.