增加MAP保存液体积对红细胞保存质量的影响

Effect of increased MAP preservation solution volume on the quality of stored RBCs

目的:观察增加MAP保存液体积对不同存储期红细胞(red blood cells,RBCs)保存质量的影响。方法:分别采集12名健康成人全血200 mL,滤白后离心去除血浆,将RBCs重悬于50 mL MAP保护液中。将制备好的RBCs悬液随机分为两组,6袋/组:一组为对照组,内含添加正常比例MAP的RBCs,另一组为观察组,继续加入50 mL MAP,使其内含2倍体积的保护液,4℃保存。于储存期0 d、7 d、14 d、21 d、28 d、35 d、42 d抽取血样5 mL,分别检测RBCs形态、平均体积(MCV)、聚集指数、相对溶血率、上清丙二醛(MDA)含量、高铁血红蛋白分数(FMetHb)、p H值以及葡萄糖(cGlu)、ATP、乳酸(cLac)浓度。结果:对照组和观察组变形RBCs数量、RBCs聚集指数、RBCs相对溶血率、MDA、FMetHb及cLac水平均随时间延长不断增加,而MCV、p H、cGlu和ATP水平随存储时间延长逐渐降低;在存储期7 d、14 d、21 d、28 d、35 d、42 d,与对照组相比,观察组变形RBCs数量、相对溶血率及MDA的增高倍数均升高(P <0. 05)。结论:增加MAP保护液体积虽然能有效降低RBCs聚集指数,但却加重RBCs变形、膜脂质过氧化及RBCs破坏。

Objective： To observe the effect of increased MAP preservation solution volume on the quality of stored red blood cells（ RBCs） at different storage time. Methods： 12 healthy adults were recruited,and 200 ml of whole blood was collected from each of them. After filtering the white blood cells,the blood was centrifuged to remove the upper plasma and then the packed RBCs were resuspended in 50 ml MAP solution. The above 12 blood bags were randomly divided into two groups,and each group had 6 bags： One group acted as control group,containing normal proportion of MAP solution,while the other group acted as experimental group,containing 2 times volume of MAP solution（ another 50 mL MAP was added）. At shelf life of 0,7,14,21,28,35 and 42 days,5 mL of blood sample was taken and then the morphology,mean volume（ MCV）,aggregation index,relative hemolysis rate,malondialdehyde（ MDA） content,methemoglobin fraction（ FMet Hb）,p H value and glucose（ cGlu）,ATP and lactic acid（ cLac） concentration were detected. Results： In both control and experimental group,the deformed RBCs,RBC aggregation index,RBC relative hemolysis rate,MDA,FMet Hb and cLac level all increased with the prolongation of time; however,MCV,pH,cGlu and ATP levels decreased gradually. Compared with the control group,the relative increase of deformed RBCs,relative hemolysis rate and MDA was higher in the experimental group at 7,14,21,28,35,and 42 days（ P 〈 0. 05）. Conclusion： Increasing the volume of MAP solution can effectively reduce the aggregation index of RBCs,but aggravates the deformation,membrane lipid peroxidation and destruction of RBCs.