不同时间段的去白膜血浆制备冷沉淀凝血因子的质量评价

Quality evaluation of cryoprecipitate coagulation factors from buffy coat⁃derived plasma at different time periods

目的评价室温(20~24)℃新鲜全血在不同时间段分离白膜后制备浓缩血小板后的血浆再制备冷沉淀的质量,找出制备冷沉淀的最适时间,以提高血液综合利用率。方法随机抽取本站2020年10—12月采用六联袋(CPDA⁃1)采集后于(20~24)℃条件下保存的全血250袋为实验组,按制备时间分为A1(0~8 h)、A2(8~10 h)、A3(10~12 h)、A4(12~14 h)、A5(14~16 h)5组,每组50袋,分离出白膜上层的血浆冻作为制备冷沉淀的起始血浆。同时另随机选取(2~6)℃常规保存0~16 h内制备的新鲜冰冻血浆50袋作为对照组(B组),将其作为起始血浆制成冷沉淀。检测凝血因子Ⅷ(Ⅷ因子)和纤维蛋白原(FIB);比较不同制备时间和不同保存温度对Ⅷ因子和FIB含量及合格率。结果与对照组相比,A4、A5组Ⅷ因子含量明显降低,A4、A5、B组比较差异有统计学意义(P<0.001);不同时间段制备去白膜血浆对冷沉淀FIB质量影响的差异无统计学意义(P>0.05);实验组去白膜血浆制备冷沉淀Ⅷ因子含量≥60 IU/袋的占96.4%(1.5 U)。结论采集后全血在(20~24)℃条件下12 h内制备浓缩血小板后的去白膜血浆适合用于制备2 U的冷沉淀凝血因子,(12~16 h)内制备浓缩血小板后的去白膜血浆适合用于制备1.5 U的冷沉淀凝血因子。

Objective To investigate the quality of cryopre⁃cipitates prepared from buffy coat⁃derived plasma of fresh whole blood at room temperature 20℃-24℃isolated at different time periods,explore the optimal time for preparing cryoprecipi⁃tates,so as to improve the utilization rate of blood.Methods A total of 250 bags of whole blood collected by CPDA⁃1 and stored at 20℃-24℃from October 2020 to December 2020 were randomly selected as the experimental group,and divided into groups A1(0-8 h),A2(8-10 h),A3(10-12 h),A4(12-14 h)and A5(14-16 h)(with 50 bags in each group)according to the preparation time point.The upper⁃buff⁃coat plasma was separated and quickly frozen as the source for cryo⁃precipitates.Meanwhile,another 50 bags of fresh frozen plasma prepared within 0-16h after routine storage at 2℃-6℃were randomly selected as the control group(group B),which was used as the raw plasma to make cryoprecipitate.Coagulation factorⅧ(Ⅷfactor)and fibrinogen(FIB)were detected,and the effect of different preparation time and different storage temperature on the content of factorⅧand FIB and the pass rate were compared.Results In comparison to the control group,theⅧfactor content of groups A4 and A5 was significantly decreased,and the differences between groups A4,A5 and B were statistically significant(P<0.001).There was no statistically significant difference in the effect of preparation of buffy coat⁃derived plasma on the FIB quality of cryoprecipitate in different time periods(P>0.05).The FactorⅧcontent≥60 IU/bag prepared from buffy coat⁃derived plasma accounted for 96.4%(1.5 U)in the experimental group.Conclusion The buffy coat⁃derived plasma prepared within 12 h at 20℃-24℃is suitable for preparing 2 U cryoprecipitate coagulation factor,while that prepared within 12-16 h is suitable for preparing 1.5 U cryoprecipitate coagulation factor.