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目的探讨急性白血病完全缓解期患者自体血小板深低温保存后,血小板功能和数量的变化,为临床使用自体冻存血小板提供实验室依据。方法应用血栓弹力图、流式细胞术和全血细胞分析仪,分析54份来自急性白血病诱导化疗后完全缓解、同时微小残留病(minimal residual disease,MRD)阴性患者的自体血小板样本,在-80℃保存30 d,其血小板功能及数量的变化。结果凝血因子水平(R值)和纤维蛋白原水平(K值,α角)变化不明显,但血小板聚集功能(MA值)明显增强,差异有统计学意义(P<0.05)。新鲜血小板组的CD42b表达率较高,为(92.23±3.59)%;经深低温保存,37℃水浴复融后冰冻保存血小板组的CD42b表达率降低为(52.67±7.79)%,差异有统计学意义(t=24.96,P<0.05)。冰冻保存血小板组PLT较新鲜血小板组减少;而PDW和MPV较新鲜组增大,差异均有统计学意义(P<0.05)。结论急性白血病完全缓解期患者采集自体血小板经-80℃冰冻保存和复融,血小板数量有部分减少,但仍然满足回输要求,同时血小板聚集功能增强,对预防或治疗严重骨髓抑制期出血具有保护作用,值得临床推广应用。
Objective To investigate the changes of platelet function and quantity after autologous platelet cryopreservation in patients with complete remission of acute leukemia and to provide a laboratory basis for the clinical use of cryopreserved platelets. Methods Fifty-four autologous platelet samples from patients with complete remission after acute leukemia induction chemotherapy and minimal residual disease (MRD) negative patients were analyzed using thromboelastography, flow cytometry and whole blood cell analyzers at -80 ° C Preservation of 30 d, the platelet function and quantity changes. Results There was no significant change in coagulation factor (R) value and fibrinogen level (K value, α angle), but the platelet aggregation function (MA value) was significantly increased. The difference was statistically significant (P <0.05). The expression rate of CD42b in fresh platelet group was (92.23 ± 3.59)%, which was significantly lower than that in cryopreserved platelet group (52.67 ± 7.79%) after cryopreservation. The difference was statistically significant Significance (t = 24.96, P <0.05). Compared with the fresh group, the PLT of cryopreserved platelet group was lower than that of fresh platelet group, but the differences were statistically significant (P <0.05). Conclusions In patients with complete remission of acute leukemia, autologous platelets were cryopreserved and thawed at -80 ° C, and the number of platelets was partly reduced. However, they still met the requirement of reinfusion and enhanced the platelet aggregation function, which was protective for the prevention or treatment of severe myelodysplastic bleeding Role, it is worth promoting clinical application.