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目的考察浓缩血小板混合后在一次性滤除白细胞血小板贮存袋保存过程中的质量变化。方法采用富血小板血浆法(PRP法)从400 mL新鲜全血制备浓缩血小板,将10-12 U(1 U约30 mL)ABO血型同型的浓缩血小板混合并滤除白细胞后,注入一次性滤除白细胞血小板贮存袋振荡保存,共完成10例(袋);分别于滤除白细胞前、后以及保存d1、d3、d5、d7观察涡流现象,检测pH值、血细胞计数、血小板聚集、血小板低渗休克(HSR)、血小板形变能力(ESC),CD62p阳性表达率、血小板ATP含量、葡萄糖和乳酸含量等指标。结果 1个成人治疗剂量的混合浓缩血小板滤除白细胞后血小板回收率(86.7±1.6)%,HSR(3.87±12.75)%,剩余白细胞数(0.15±0.15)×106个,滤除白血病前、后血小板pH值、HSR(%)和CD62p阳性率(%)分别为7.00±0.17 vs 7.06±0.16、66.96±12.35 vs 63.22±8.26、28.94±14.25 vs 31.60±16.77,花生四烯酸诱导时的聚集率(%)106.2±23.5 vs 106.5±20.1,ADP+肾上腺素诱导时的聚集率(%)104.8±19.0 vs 106.5±18.6(P>0.05)。随着保存时间的延长,混合浓缩血小板的各项指标绝对值发生变化:保存d1及d5(有效保存期末)的pH值、HSR(%)、CD62p(%)及ESC(%)分别为7.27±0.12 vs 7.13±0.21、62.28±6.93 vs 65.53±8.23、30.27±9.06 vs 34.45±14.23、14.28±2.01 vs 8.55±4.12,花生四烯酸诱导时的聚集率(%)92.2±6.1 vs 86.3±23.1,ADP+肾上腺素诱导时的聚集率(%)为93.2±6.7 vs 44.5±41.6。ATP(μmol/1011个血小板)、乳酸(mmol/L)、葡萄糖(mmol/L)分别为5.40±1.66 vs 4.97±1.01、8.35±2.94 vs 13.87±2.97、24.55±1.53vs 20.75±2.04。结论浓缩血小板经混合、滤除白细胞后放入一次性滤除白细胞血小板贮存袋中保存,保存过程中其质量符合国家标准,可以作为临床单采血小板的补充。
Objective To investigate the quality changes of platelets after one-time filtration of leucocyte platelet storage bags after mixing with platelets. Methods Concentrated platelets were prepared from 400 mL of fresh whole blood by platelet-rich plasma (PRP) method. After the platelets of 10-12 U (1 U about 30 mL) homogenous platelets of ABO blood type were mixed and leukocytes were filtered off, 10 cases (bag) were completed in the storage of leukocyte platelets. Eddy currents were observed before and after leukocyte filtration, and d1, d3, d5 and d7, respectively. The eddy currents were observed and the pH value, blood cell count, platelet aggregation and platelet hypotonic shock (HSR), platelet deformability (ESC), CD62p positive expression, platelet ATP content, glucose and lactate content and other indicators. Results The recovery rate of platelets after mixed leukocyte transplantation with an adult dose of 86.7 ± 1.6%, HSR (3.87 ± 12.75)%, and the number of remaining white blood cells (0.15 ± 0.15) × 106 was significantly lower than that before leukemia The positive rate (%) of platelet pH, HSR (%) and CD62p were 7.00 ± 0.17 vs 7.06 ± 0.16, 66.96 ± 12.35 vs 63.22 ± 8.26, 28.94 ± 14.25 vs 31.60 ± 16.77 respectively. The aggregation rate of arachidonic acid upon induction (%) 106.2 ± 23.5 vs 106.5 ± 20.1, ADP + epinephrine induced aggregation rate (%) 104.8 ± 19.0 vs 106.5 ± 18.6 (P> 0.05). The absolute values of various indicators of mixed platelets changed with the prolongation of storage time. The values of HSR (%), CD62p (%) and ESC (%) were 7.27 ± 0.12 vs 7.13 ± 0.21, 62.28 ± 6.93 vs 65.53 ± 8.23, 30.27 ± 9.06 vs 34.45 ± 14.23, 14.28 ± 2.01 vs 8.55 ± 4.12, arachidonic acid-induced aggregation rate (%) 92.2 ± 6.1 vs 86.3 ± 23.1, The rate of aggregation (%) upon ADP + epinephrine induction was 93.2 ± 6.7 vs 44.5 ± 41.6. ATP (μmol / 1011 platelets), lactate (mmol / L) and glucose (mmol / L) were 5.40 ± 1.66 vs 4.97 ± 1.01, 8.35 ± 2.94 vs 13.87 ± 2.97, 24.55 ± 1.53 vs. 20.75 ± 2.04 respectively. CONCLUSION: Concentrated platelets are mixed and leucocytes are filtered off and placed in disposable leucocyte platelet storage bags. The quality of the preserved platelets meets the national standards during the storage process, which can be used as a supplement to clinical platelets.