新鲜冰冻血浆融化后不同保存时间及温度对凝血功能的影响

Effects of Different Storage Time and Temperature on Coagulation Function of Fresh Frozen Plasma after Thawing

目的:探讨新鲜冰冻血浆融化后不同保存时间及温度下凝血功能的变化,为临床合理有效输注新鲜冰冻血浆提供理论依据。方法:留取新鲜冰冻血浆40例,在融浆机37℃25 min融化后均分为2份,1份于(4±2)℃条件下保存,另1份于(25±2)℃条件下保存,所有样本在融化后0、4、24、48和72 h分别进行血栓弹力图检测,同时进行凝血因子Ⅴ、Ⅶ、Ⅷ、Ⅸ活性以及APTT和PT检测,并对每份样本进行需氧菌和厌氧菌血培养。结果:新鲜冰冻血浆融化后在4℃和25℃保存72 h后均能形成稳定血凝块,且无细菌生长,反应凝血因子活性及血凝块特性的ACT和TMA在保存4、24、48和72 h时间点与0 h相比均存在显著差异(P<0.05),但同一保存时间点的两个不同温度间无差异。新鲜冰冻血浆融化后保存48和72 h时凝血因子Ⅴ活性水平在4℃与25℃之间存在显著差异(P<0.05),25℃温度保存时活性衰减比4℃温度保存时快。结论:新鲜冰冻血浆融化后保存72 h时虽然有部分凝血因子活性的衰减,但仍能形成稳定血凝块,临床血浆输注过程中融化后保存72 h的血浆可用于临床患者凝血因子的补充,尽量避免血液成分的浪费。

Anstract Objective： To investigate the coagulation function changes of fresh frozen plasma storaged at different storage time and temperature after thawing. Methods： Forty unit of fresh frozen plasma were collected, and thawed at 37 ℃ for 25 minutes. Each unit was divided into 2 halves： one was stored at（4 ± 2）℃ for 72 hours and the other one was stored at （25 ± 2） ℃ for 72 hours. At the time point of 0, 4, 24, 48 and 72 h, thromboela-stogram TEG was measured for all samples. At the the same time, factors V, VII, Will and IX, APTT and PT were also measured for all the samples. Blood culture for all the samples was used to discover aerobic and anaerobic bacteria. Results： All the samples could form a stable blood clot after thawing for 72 h, and the blood culture results of all samples were negative. Significant changes were observed in ACT and TMA between 0 h and other test time, but there was no difference between 4 ℃ and 25 ℃. The activity of factor V was significantly different between 4 ℃ and 25 ℃ after storing for 48 and 72 hours, which was reduced faster at 25 ℃. Conclusion： Although part of the coagulation factor activity were attenuated after fresh frozen plasma being thawed and stored for 72 hours at different temperature , but all samples can form stable blood clots. Fresh frozen plasma stored for more than 72 hrs after thawing can be used to supplement the coagulation factors to oatient.