用于高钾血症贫血患者的洗涤红细胞可保存时间的研究

The study of the longest storage time of washed red blood cells used for hyperkalemia anemic patients

目的探讨用于高钾血症患者输注的洗涤红细胞最长保存时间。方法将8份2U(200mL/U)悬浮红细胞用生理盐水洗涤后,均分为2份,分别悬浮于MAP红细胞添加液(MAP组)和生理盐水(盐水组)中以2-6℃保存,分别于0、5、20h及1、2、3、4、5、6、7d时取样,检测上清中K+浓度([K+])、计算K+总量,并分析生理盐水及MAP液悬浮的2种洗涤红细胞常规质控抽检结果。结果保存0-7d,盐水组和MAP组悬浮红细胞[K+](mmol/L)的变化几无差异(P>0.05),均随保存时间逐渐升高,其中在1d时盐水组和MAP组分别为3.17±0.69vs3.75±0.30,均低于人体[K+]正常参考范围上限(5.5);保存2d时2组均已有部分样品[K+]>5.5。0-7dMAP组K+总量低于盐水组(P<0.05),其中保存2d时K+总量(μmol)MAP组与盐水组分别为229.6±44.8vs277.3±52.5,均高于保存1d时的盐水组174.1±29.1(P<0.05)。无论是生理盐水悬浮还是MAP液悬浮,洗涤红细胞常规质控抽检项目结果均符合国标规定。结论对于高钾血症贫血患者这部分特殊人群,若以不超过人体[K+]参考范围上限为依据,则MAP液保存的洗涤红细胞以≤24h为宜。

Objective To study the longest storage time of washed red blood cells（RBCs） used for hyperkalemia anemic patients.Methods After being washed by saline,eight bags of 2U suspended RBCs（200mL/U） were equally divided into 2 parts and suspended in MAP additive solution（MAP group） and physiological saline（saline group） respectively and stored at 2- 6℃.Samples were taken at 0,5,20h and 1,2,3,4,5,6 and 7 d after preparation respectively to measure[K＋].Total amount of K＋was calculated.Routine quality control of sampling results of washed RBCs suspended in saline or MAP were analyzed.Results There were no significant difference on the amount of [K＋]（mmol/L） of washed RBCs between these two groups（P0.05）.Both exhibited a gradual increase with the prolongation of 0- 7d storage time.The[K＋]of MAP group and saline group at 1d after preparation was 3.17±0.69 VS 3.75±0.30.The [K＋]of all samples from both groups were still lower than the upper reference limit of [K＋]in normal human bodies（5.5mmol/L）.However,the [K＋]of some samples from both groups at 2d had exceeded 5.5 mmol/L.During the 0- 7d storage period,the total amount of K＋of MAP group（229.6±44.8） at 2d was lower than that of saline group（277.3±52.5）（P0.05）,but was higher than total amount of K＋of saline group at 1d after preparation（174.1±29.1）（P0.05）.Routine quality control of sampling results of washed RBCs suspended in either saline or MAP both met the quality requirements on washed RBCs by GB18469- 2012.Conclusion For hyperkalemia anemic patients,the storage time of washed RBCs preserved in MAP should not exceed 24 h,using the upper limit of [K＋]in normal human bodies as standard reference.