非标示量血液制备去白细胞悬浮红细胞的质量分析

Quality analysis of leukocyte free suspended red blood cells prepared from blood that does not match the labeled volume

目的利用非标示量血液制备成去白细胞悬浮红细胞(LD-AS红细胞),观察其在不同时间内血液的质量变化,探讨非标示量血液再利用的可行性。方法随机选取2020年4月—2021年10月天津市滨海新区塘沽中心血站所采集的30袋非标示量血液作为实验组,制备成标示量1U的LD-AS红细胞形成实验组;随机选取2019年2月—2021年7月本血站的30袋标示量为1U的正常去白悬浮红细胞作为对照组。分别测定血液容量、期末红细胞压积(Hct)、血红蛋白浓度(HGB)、血红蛋白含量(Hemoglobin content)、白细胞残留量,在血液不同保存期内的第0天、7天、14天、21天、28天、35天六次测量血液样本中的pH值、血浆游离血红蛋白(f-Hb)、红细胞内2,3-二磷酸甘油酸(2,3-DPG),保存期末计算血液的溶血率并进行细菌学培养。结果与对照组相比较,实验组中血液容量、Hct、HGB、血红蛋白含量、白细胞残留量均无显著差异(P>0.05),血液期末溶血率存在着明显差异(P<0.05),实验组中测量的pH值,差异具有统计学意义(P<0.05),血浆f-Hb在血液储存7天后,差异具有统计学意义(P<0.05),红细胞内2,3-DPG含量在血液储存第7天、28天、35天,差异具有统计学意义(P<0.05)。实验组血液的pH值、血浆f-Hb、红细胞内2,3-DPG,随着其储存时间的延长而出现明显差异(P<0.05)。储存期末对每袋血液进行细菌培养,均无细菌生长。结论非标示量血液制备成1U的LD-AS红细胞后,血液质量检测结果均达到《全血成分血质量要求GB18469-2012》(简称《国标》)所规定的标准。但随着储存时间的延长,实验组血液中的pH值、血浆f-Hb、红细胞内2,3-DPG指标与对照组会出现一定变化。因此为保证临床用血的安全性、有效性,故推荐非标示量LD-AS红细胞在制作成1U的LD-AS红细胞应在21天内临床使用。

Objective To prepare leucocytes depleted red blood cells in additive solution(LD-AS erythrocytes)from blood that does not match the labeled volume,an to observe the changes of blood quality at different times points,and explore the feasibility of reuse of blood that does not match the labeled volume.Methods 30 bags of blood does not match the labeled volume collected by Tanggu central blood station in Tianjin Binhai New Area from April 2020 to October 2021 were randomly selected as the experimental group,and the LD-AS erythrocytes with labeled amount of 1U was prepared by using the samples,and formed experimental group.30 bags of normal leukocyte-depleted suspended erythrocytes with labeled amount of 1U from our blood station from February 2019 to July 2021 were randomly selected as the control group.The blood volume,terminal hematocrit(HCT),hemoglobin concentration(HGB),hemoglobin content and leukocyte residue were measured.The pH value in blood samples,plasma free hemoglobin(f-Hb)and 2,3-diphosphoglyceride(2,3-DPG)in erythrocytes were measured at the time points of 0,7th,14th,21th,28th,and 35th day during the storage life.At the end of storage,the hemolysis rate of blood was calculated and bacteriological culture was carried out.Results There was no significant difference in blood volume,HCT,HGB,hemoglobin content and leukocyte residue between control group and the experimental group(P>0.05),and there was significant difference in the hemolysis rate at the end of the blood storage period(P<0.05).The difference in pH value was statistically significant between the two groups(P<0.05).After 7 days of blood storage,the difference in plasma f-Hb was statistically significant between the two groups(P<0.05).There were significant difference in the content of 2,3-DPG in erythrocytes on the 7th,28th and 35th days of blood storage(P<0.05).The pH value of blood,plasma f-Hb and 2,3-DPG in erythrocytes in the experimental group showed significant differences with the extension of storage time(P<0.05).At the end of storage,bacterial culture was carried out for each bag of blood,and there was no bacterial growth.Conclusions After preparing LD-AS erythrocytes of 1U from blood that does not match the labeled volume,the blood quality test results meet the standards specified in the requirements for blood quality of whole blood components GB 18469-2012(hereinafter referred to as the national standard).However,with the extension of storage time,the pH value in blood,plasma f-Hb and 2,3-DPG in erythrocytes in the experimental group will change to some extent compared with the control group.Therefore,in order to ensure the effectiveness of clinical blood use,it is recommended that LD-AS erythrocytes(1U)made from blood that does not match the labeled volume should be used clinically within 21 days after been prepared.