去白细胞机采血小板膜表面CD62P及血栓弹力图变化分析

Analysis on changes of CD62P and thrombelastogram of leukocytes reduced apheresis platelets

目的 掌握去白细胞机采血小板在保存期内的功能变化,为临床输注成分血提供参考依据.方法 选择2010年5月至2014年1月于日照市中心血站无偿献血的30例无偿献血者的血样为研究对象.男性献血者为21例,女性为9例;年龄为19～42岁,平均为25.2岁.所有献血者均符合《献血者健康检查要求》（GB18467-2011）.所有血液的采集均获得献血者知情同意,并在知情同意一栏签字后献血.通过白细胞过滤方法制备去白细胞机采血小板,于（22±2）℃血小板恒温振荡保存箱中振荡保存,并分别于保存前以及保存后第1,3,5及7天检测去白细胞机采血小板膜表面CD62P（P选择素）的表达率和血栓弹力图（TEG）,进而评价随保存时间延长血小板功能的变化情况.结果 ①去白细胞机采血小板保存前白细胞残余量为（5.9±2.1）×105/袋,保存至第5和7天,白细胞残余量相对于保存前明显减少,且差异均有统计学意义（P＜0.05）,白细胞残余量随保存时间的延长而减少.②去白细胞机采血小板保存前血小板膜表面CD62P表达率较低,仅为（10.3±2.3）％,保存后第3,5及7天与保存前比较,血小板膜表面CD62P表达率均显著增加,且差异均有统计学意义（P＜0.05）,并随保存时间延长,血小板膜表面CD62P表达率逐渐增加.③去白细胞机采血小板保存后第1,3,5及7天R值较保存前显著增加,差异均有统计学意义（P＜0.05）,且R值随保存时间延长呈明显增加趋势.而K值和α角在保存期内与保存前比较,差异均无统计学意义（P＞0.05）.保存后第5,7天MA值较保存前显著降低,差异均有统计学意义（P＜0.05）.结论 去白细胞机采血小板在保存期内存在明显的血小板损耗,但对其凝血功能影响不大,保存5d内的去白细胞机采血小板仍是比较理想的成分血.

Objective To research the function changes of leukocytes reduced apheresis platelets during storage period and to guide the reasonable clinical usage of leukocytes reduced apheresis platelets.Methods From May 2010 to January 2014,a total of 30 cases of blood donors＇ blood sample in Rizhao Blood Center were included into this study.Male donors were 21 cases and female were 9 cases.Donors＇ages were 19 to 42 years old,and average age was 25.2 years old.All donors were confirmed by the ＂Requirements of Donor Health Examination＂ （GB18467-2011）.Informed consent was obtained from all donors before blood collection.Leukocytes reduced apheresis platelets were prepared through leukocytes filtration method and were preserved at （22 ± 2） ℃ for 7 days.The expression of CD62P and the test of thrombelastogram （TEG） were used to evaluate the function changes of leukocytes reduced apheresis platelets during storage period.Results （①） Before preservation,residual leukocytes of freshly collected platelets were （5.9±2.1） × 105/bag,but it decreased at the first 5 and 7 days of storage compared with before preservation and the differences were statistically different （P〈 0.05）.② Before preservation,CD62P expression of freshly collected platelets only was （10.3 ± 2.3）%.But it increased significantly in the first 3,5 and 7 days of storage compared with before preservation and the differences were statistically different （P〈0.05）.③The parameter R value of TEG increased obviously during storage period compared with before preservation,and the differences were statistically different （P〈0.05）.While the parameter K value and α angle did not changed obviously during the whole storage period compared with before preservation,and the differences were not statistically different （P〉 0.05）.The parameter MA value decreased significantly in the first 5 and 7 days during storage compared with before preservation and the differences were statistically different （P〈 0.05）.Conclusions The loss of platelets is obvious during storage period,but the coagulation function of leukocytes reduced apheresis platelets is still good in 5 days storage.So leukocytes reduced apheresis platelet within 5 days preservation is still an ideal blood component.