国产某型^(137)Cs γ射线辐照仪辐照血液制品的应用研究

Application study on blood product irradiation by homebred 137Cs γ-ray blood irradiator

目的:研究某型国产^(137)CSγ射线血液辐照机辐照后血液制品质量以及血液制品中淋巴细胞增殖能力的变化,评估患者输注后的临床疗效。方法:选取悬浮红细胞和单采血小板为试验对象,分为对照组和辐照组,使用某型国产^(137)Csγ射线血液辐照仪进行辐照,试验用辐照剂量为25 Gy。对悬浮红细胞组进行红细胞计数(RBC)、血细胞比容(Hct)、红细胞平均体积(MCV)、血浆游离血红蛋白(FHb)检测,分离红细胞中的淋巴细胞进行增殖培养。血小板组进行血小板计数(PLT)、血小板平均体积(MPV)检测。计算悬浮红细胞和血小板的破坏率、回收率,计算淋巴细胞增殖能力的下降指数;同时对接受血液制品输注的患者进行血常规、肝功能和肾功能检测,评估输血前后生理功能的变化和输血疗效。结果:红细胞组辐照后与辐照前比较,RBC、Hct、MCV、FHb差异无统计学意义(P>0.05);淋巴细胞增殖率下降,差异有统计学意义(P<0.05)。血小板组辐照后与辐照前比较,PLT、MPV差异无统计学意义(P>0.05);红细胞和血小板的破坏率、回收率符合要求。患者接受血液制品输注后肝功能、肾功能实验室检测数据变化差异无统计学意义(P>0.05),无输血不良事件发生,输血疗效变化差异有统计学意义(P<0.05)。结论:该型辐照机辐照后血液制品质量和功能未受影响,淋巴细胞增殖率下降,受血者接受辐照后血液制品输注疗效明显,无输血不良反应。

Objective：To investigate the quality changes and the effect on the proliferation of lymphocyte,and of suspended red blood cells and platelet irradiated by homebred 137 Cs γ~ray blood irradiator with the dose of 25 Gy,and explore the changes of patient who had received irradiant red blood cells or irradiant platelets transfusions.Method：The suspended red blood cells and platelets were irradiated by 137 Cs y-ray homebred blood irradiator with the dose of 25 Gy,and the lymphocytes were isolated from the suspended red blood cells before and after irradiation,cultured for observing the changes of cellular proliferation rate,RBC,Hct,MCV and free Hb were detected in suspended blood cell group,PLT,MPV and aggregation rate were detected in platelet group,and recovery was detected in both groups.At the same time,the detection for liver and kidney function of patients who had received the irradiant red blood cells or irradiant platelets transfusions were detected.Result;There was significant difference in the rate of lymphocytes proliferation between the two groups（P〈0.05）.There were significant differences in physicochemical indexes of suspended red blood cells before and after irradiation.There were significant differences in PLT and MPV of platelet before and after irradiation.Conclusion：The rate of lymphocytes proliferation of suspended red blood cells decreased significantly after irradiation by the homebred 137 Cs γ-ray blood irradiator,and irradiant red blood cells could be applied for special disease to prevent TA-GVHD effectively.