富血小板血浆的采集影响因素探讨

Influencing factors of platelet-rich plasma collection

目的探讨影响富血小板血浆(PRP)采集及产品质量的因素,为保障PRP采集的安全性和PRP产品的质量提供参考。方法对2020年2月~2021年6月在本院行PRP治疗的149名患者,从性别、年龄、采集前Plt、采集仪器4个因素对PRP采集时间、循环血量、抗凝剂用量、钙剂使用,PRP产品容量、血小板含量、白细胞和红细胞混入量及献血不良反应发生的影响进行统计分析。结果仪器因素对采集指标及产品的影响差异不显著(P>0.05);产品中男、女性患者RBC残存量分别为(0.04±0.02,0.07±0.03)×10^(12)/L,女性高于男性患者(P<0.05);年龄较低组(18~40岁)、血小板计数较高组(201~450)×10^(9)/L的患者与年龄较高组(56~77岁)、Plt较低组(100~150)×10^(9)/L的患者比较,在采集时间、循环血量、抗凝剂用量、采集量上的差异有统计学意义(P<0.05);采集前Plt较低组(100~150)×10^(9)/L的患者,PRP产品中的Plt相对也较低(771±218)×10^(9)/L,WBC、RBC残留量相对较高,分别为(0.45±0.25)×10^(9)/L,(0.07±0.03)×10^(12)/L,差异具有统计学意义(P<0.05),但仍能满足治疗需求。结论 MCS+和NGL XCF 3000 2种血细胞分离机采集PRP均安全稳定,血小板计数在(100~150)×10^(9)/L及年龄偏大(>55岁)的患者采集PRP也安全可行。

Objective To explore the factors affecting the collection and product quality of platelet-rich plasma(PRP), and to provide reference for ensuring the safety of PRP collection and the quality of PRP products. Methods A total of 108 patients receiving PRP treatment in our hospital from February 20 to April 20, 2016 were investigated by analyzing the time of PRP collection, the amount of circulating blood, the amount of anticoagulant and the use of calcium from four factors including gender, age, Plt before collection and collection equipment. The effects of PRP product volume, platelet content, RBC and WBC contamination, and the occurrence of adverse reactions were statistically analyzed. Results The type of equipment had little influence on the collection parameters and product quality(P>0.05). RBC residues in female patients were(0.07±0.03) ×10^(12)/L, higher than that in male patients(0.04±0.02)×10^(12)/L(P<0.05). Significant differences in collection time, circulating blood volume, anticoagulant dosage and collection volume were noticed by age(18~40 vs 56~77 years old, P<0.05) and platelet count(×10^(9)/L)(201~450 vs 100~150, P<0.05). In patients with low Plt count(100~150)×10^(9)/L before collection, the Plt content in PRP product was relatively low(771±218)×10^(9)/L, and WBC(0.45±0.25)×10^(9)/L and RBC(0.07±0.03)×10^(9)/L residual amount was rather high(P<0.05), but also satisfied the quality criteria. Conclusion The MCS+ and NGL XCF 3000 blood cell separators are safe and stable in PRP collection, even in patients with low platelet count(100~150)×10^(9)/L or old age(>55 years old).