添加不同比例的MAP保存液对拉萨地区悬浮红细胞保存质量的影响

The influence of different ratio of additive solution MAP on the storage quality of suspension red blood cells in Tibet

目的比较添加不同比例的MAP保存液对西藏拉萨地区悬浮红细胞的保存质量的影响。方法将西藏自治区血液中心采集的400 m L全血(共6袋),每袋平均分成2份,每份再分别离心分离去除血浆,按全血与保存液的不同比例包括4∶1和4∶1.5,每份红细胞分别加入50 m L(对照组)和75m L MAP保存液(实验组)制备得到悬浮红细胞,每份分别分装到4个50 m L小袋,于1、7、14、35 d分别检测血常规、p H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。结果在保存d1,实验组的红细胞数、Hb浓度、Hct、血液粘度都明显低于对照组,分别为(5.66±0.49)vs(6.72±0.68)×1012/L,(178.2±13.03)vs(212.6±14.2)g/L,(63.7±5.9)%vs(53.7±4.7)%,(6.99±1.82)vs(11.60±2.86)10s-1,至保存末期,两组仍保持这一规律。尽管对照组与实验组的红细胞变形指数和渗透脆性在保存期间差异不大,但在保存的d1和d7,对照组的溶血率仍明显高于实验组,分别为(0.070±0.039)vs(0.045±0.039)%和(0.116±0.066)vs(0.070±0.055)%。另外,在排除红细胞浓度的影响后,保存过程中对照组的葡萄糖的代谢速率仍明显快于实验组,为(2.43±0.66)vs(1.93±0.41)mmo L/L/1012个红细胞。结论 2组悬浮红细胞相比,添加正常比例1.5倍的MAP制备的西藏拉萨高海拔的悬浮红细胞的红细胞数、Hb浓度、Hct和血液粘度都明显降低,有利于临床输注。除此之外,红细胞保存液的增加有利于减缓葡萄糖的消耗和减少溶血,对高海拔地区悬浮红细胞的保存质量有一定的改善作用。

Objective To compare the influence of different ratios of additive solution on the storage quality of suspended red blood cells prepared from Tibetan plateau. Methods The 400 m L blood collected from Tibet blood center（ n = 6）was equally divided into two bags,followed by centrifugation. The plasma was removed,and the packed red blood cells（ RBCs） were suspended in additive solution MAP with different volumes,including 50 m L（ control group） and 75 m L（ experimental group）. Then,equal volumes were divided into four separate bags and were sampled aseptically at Day 1,7,14 and 35 of storage. Routine blood counts,p H,whole blood viscosity,electrolytes,glucose,lactic acid,free hemoglobin（ FHb）,osmotic fragility and the deformability of RBCs were evaluated,respectively. Results The numbers of RBC,concentration of hemoglobin,hematocrit（ Hct） and blood viscosity of experimental group were significantly lower than control group,and the results were（ 5. 66 ± 0. 49） vs（ 6. 72 ± 0. 68） × 1012/ L,（ 178. 2 ± 13. 03） vs（ 212. 6 ± 14. 2） g / L,（ 63. 7± 5. 9） % vs（ 53. 7 ± 4. 7） %,（ 6. 99 ± 1. 82） vs（ 11. 60 ± 2. 86） 10s-1,respectively. Although there was no significant difference in the deformability and the higher osmotic fragility of RBC between the two groups,the rate of hemolysis of control group was significantly higher than experimental group at day 1 and day 7 of storage period,and the results were（ 0. 070 ±0. 039） vs（ 0. 045 ± 0. 039） % and（ 0. 116 ± 0. 066） vs（ 0. 070 ± 0. 055） %,respectively. In addition,excluding the influence of concentration of RBC,the metabolism rate of glucose in control group was still faster than the experimental group,and the results were（ 2. 43 ± 0. 66） vs（ 1. 93 ± 0. 41） mmo L / L /1012 RBC. Conclusion Compared to the suspension RBCs prepared from normal ratio of additive solution in Tibetan plateau,the number of RBC,the concentration of Hb,Hct and blood viscosity of RBCs prepared from 1. 5 times of normal ratio additive solution MAP showed a significant reduction,which made for better clinical transfusion. In addition,the increase in additive solution volume is beneficial for decreasing the consumption of glucose and hemolysis rate. Furthermore,the storage quality of suspension RBCs prepared from plateau blood was improved to some extent.