高原地区悬浮红细胞保存质量研究

The study of storage quality of suspended red blood cells in Tibetan plateau

目的考察西藏拉萨地区悬浮红细胞的保存质量。方法将西藏自治区血液中心采集的400 mL全血(共6份)离心分离,去除血浆后加入100 mL MAP保存液制备得到悬浮红细胞(实验组),并分装到4个50 mL小袋,于1、7、21、35 d分别检测血常规、pH值、全血粘度、电解质、葡萄糖、乳酸、游离Hb、红细胞渗透脆性、红细胞变形性等指标,并与悬浮红细胞(对照组)进行比较。结果实验组悬浮红细胞的红细胞数、Hb浓度、Hct、血液粘度都明显高于对照组,分别为(6.99±0.66)vs(6.02±0.33)1012/L,(202.0±16.7)vs(173.5±9.6)g/L,(61.1±4.0)%vs(56.6±2.8)%,(5.56±0.65)vs(4.44±0.25)200 s1。在保存期内,实验组悬浮红细胞的溶血率明显高于对照组,这与其红细胞变形性差、红细胞渗透脆性大是密切相关的。另外,排除红细胞浓度的影响,保存过程中实验组悬浮红细胞的K+、Na+的代谢速率也明显快于对照组的悬浮红细胞,分别为(4.24±0.25)vs(3.68±0.15)mmoL/1012个红细胞,(7.32±0.30)vs(1.41±0.21)mmoL/1012个红细胞。结论 2组的悬浮红细胞相比,与保存质量相关的多项指标存在显著性差异,因此是否需要新的红细胞保存液来制备高海拔地区的悬浮红细胞,或是结合临床试验来制定适合高海拔地区的悬浮红细胞保存的新标准,是一个值得研究和关注的问题。

Objective To explore the storage quality of suspended red blood cells in Tibet plateau. Methods The 400 mL whole blood collected from Tibet Blood Center （ n = 6） was centrifuged and the plasma was removed. Then the packed red blood cells （RBCs） were suspended in 100 mL additive solution MAP and divided into four separate bags（50 mL each）. which were sampled aseptically at day 1,7,21 and 35 of storage. Blood routine, pH, whale blood viscosity, electrolytes, glucose,lactic acid, free hemoglobin （FHb）, osmotic fragility and the deformability of RBCs were evaluated respectively. The suspended RBCs （SRBCs） collected from Deyang Blood Center was set as control group, and the SRBCs prepared from Tibet plateau blood sample was set as experimental group. Results The numbers of RBC, concentration of hemoglobin, hematocrit （Het） and blood viscosity of experimental group were significantly higher than control group, and the results are （6.99 ± 0.66 vs 6.02 ±0.33） 10^12/L, （202.0 ± 16.7 vs 173.5 ±9.6） g/L, （61.1 ±4. 0）% vs（56. 6 ±2. 8）% ,（5.56 ±0. 65 vs 4. 44 ± 0. 25 ） 200 s ^-1 respectively. The rate of hemolysis in experimental group was significantly higher than control group during storage period, which was closely related to worse deformability and higher osmotic fragility of RBC. In addition, excluding the influence of concentration of RBC, the metabolism of Na ＋ and K＋ in experimental group was significantly faster than the control group, and the results were （ 4.24 ± 0.25 vs 3.68 ± 0.15 ） mmol/10^12 RBC, （ 7.32 ± 0.30 vs 1.41 ± 0.21 ） mmol/10^12 RBC. Conclusion Several indicators of storage quality of SRBCs were significantly different between two groups. Therefore, we should pay more attention to using new additive solution for storage of the SRBCs in plateau or establishing a new standard for the storage of SRBCs in plateau.