长途火车运输对红细胞质量的影响
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摘要
目的探讨长途火车运输对红细胞质量的影响。方法选取悬浮红细胞(2 U)7袋,无菌技术将7袋悬浮红细胞各分装50 mL于7个无菌小袋,将分装的7袋50 mL标本置于4℃冰箱保存作为对照组,分装后剩余的7袋约250 mL标本作为试验组放置在血液运输箱,经长途火车运输后,分别在特定储存期测定试验组和对照组的血浆游离血红蛋白(FHb)、钾离子(K~+)、三磷酸腺苷(ATP),并计算溶血率,进行对比分析。结果在储存期7 d、14 d、28 d、35 d,试验组K~+水平[(15.82±0.34)、(10.62±0.40)、(32.96±1.52)、(55.47±5.83)mmol/L]均显著高于对照组(P<0.01);在储存期7 d、21 d、28 d、35 d,试验组FHb水平[(0.42±0.20)、(0.74±0.25)、(0.80±0.34)、(1.04±0.33)g/L]均高于对照组(P<0.05);在储存期14 d,试验组ATP水平(1.85±0.03)μmol/gHB显著低于对照组(P<0.01);试验组的溶血率在储存期7 d、14 d、21 d、28 d、35 d[(0.09±0.04)%、(0.08±0.04)%、(0.15±0.05)%、(0.16±0.07)%、(0.21±0.07)%]均显著高于对照组(P<0.01)。结论经长途火车运输后,红细胞质量明显下降,且随储存时间延长,血液质量下降更加显著,运输后的血液可以保存至21 d并应用于临床。
Objective To discuss the effect of long-distance train transportation on the quality of red blood cells(RBCs). Methods Seven bags of suspended RBCs(2 U/bag) prepared from healthy blood donors in Beijing were selected. And 50 mL of each bag was sampled as control group using aseptic technique and stored in 4℃ fridge in blood bank in Beijing The rest suspended RBCs, served as the experimental group, were placed in a standard blood container and transported by long-distance train. After the transportation,the experimental group was stored in 4℃ fridge immediately. The differences of free hemoglobin(FHb), potassium ion(K~+) and adenosine triphosphate(ATP) of two groups measured at day 0, 7, 14, 21, 28, and 35 of storage were compared and analyzed. Results The potassium concentration(mmol/L) of experimental group were significantly higher [(15.82±0.34),(10.62±0.40),(32.96±1.52)and(55.47±5.83)] than control group at day7, 14, 28 and 35(P<0.01). The free hemoglobin concentration(g/L) of experimental group were significantly higher [(0.42±0.20),(0.74±0.25),(0.80±0.34)and(1.04±0.33)] than control group at day 7, 21, 28 and 35(P<0.05).The ATP(μmol/g Hb) of experimental group at day 14(1.85±0.03) was significantly lower than control group(P<0.01). The hemolytic rate(%) of experimental group were significantly higher [(0.09±0.04),(0.08±0.04),(0.15±0.05),(0.16±0.07)and(0.21±0.07)] than control group at day 7, 14, 21,28 and 35(P<0.01). Conclusion After the long-distance train transportation, the quality of RBCs decreased obviously, and the blood quality decrease more obviously with the storage time prolonged. The blood after transportation can be preserved to 21 d and applied to the clinical.
Objective To discuss the effect of long-distance train transportation on the quality of red blood cells(RBCs). Methods Seven bags of suspended RBCs(2 U/bag) prepared from healthy blood donors in Beijing were selected. And 50 mL of each bag was sampled as control group using aseptic technique and stored in 4℃ fridge in blood bank in Beijing The rest suspended RBCs, served as the experimental group, were placed in a standard blood container and transported by long-distance train. After the transportation,the experimental group was stored in 4℃ fridge immediately. The differences of free hemoglobin(FHb), potassium ion(K~+) and adenosine triphosphate(ATP) of two groups measured at day 0, 7, 14, 21, 28, and 35 of storage were compared and analyzed. Results The potassium concentration(mmol/L) of experimental group were significantly higher [(15.82±0.34),(10.62±0.40),(32.96±1.52)and(55.47±5.83)] than control group at day7, 14, 28 and 35(P<0.01). The free hemoglobin concentration(g/L) of experimental group were significantly higher [(0.42±0.20),(0.74±0.25),(0.80±0.34)and(1.04±0.33)] than control group at day 7, 21, 28 and 35(P<0.05).The ATP(μmol/g Hb) of experimental group at day 14(1.85±0.03) was significantly lower than control group(P<0.01). The hemolytic rate(%) of experimental group were significantly higher [(0.09±0.04),(0.08±0.04),(0.15±0.05),(0.16±0.07)and(0.21±0.07)] than control group at day 7, 14, 21,28 and 35(P<0.01). Conclusion After the long-distance train transportation, the quality of RBCs decreased obviously, and the blood quality decrease more obviously with the storage time prolonged. The blood after transportation can be preserved to 21 d and applied to the clinical.
引文
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[7] 王素玲,韩卫,何路军,等.去白悬浮红细胞储存过程中ATP、2,3-DPG含量变化与氧化应激的相关性分析.河北医科大学学报,2017,38(2):192-195.
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[11] 张婵,李琦,程瑜静,等.长途运输对滤白悬浮红细胞质量影响的研究.中国输血杂志,2015,28(11):1364-1366.
[12] 中国国家标准化管理委员会.全血及成分血质量要求.北京:中华人民共和国标准化管理委员会,2001:5.
[2] 中国国家标准化管理委员会.全血及成分血质量要求.北京:中华人民共和国标准化管理委员会,2012:4.
[3] 李遥金,王翔,兰珂.血液保存对红细胞携氧功能及能量代谢的影响.中国输血杂志,2009,22(6):439-443.
[4] 杜彦茹,赵砚丽,程会平,等.自体回收血与库血红细胞酶活性及ATP含量的比较.临床麻醉学杂志,2006,22(4):261-263.
[5] Bennett-Guerrero E,Veldman TH,Doctor A,et al.Evolution of adverse changes in stored RBCs.Proc Natl Acad Sci USA,2007,104(43):17063-17068.
[6] D′Alcssandro A,Liumbruno G,Grazzini G,et al.Red blood cell storage:the story so far.Blood Transfus,2010,8(2):82-88.
[7] 王素玲,韩卫,何路军,等.去白悬浮红细胞储存过程中ATP、2,3-DPG含量变化与氧化应激的相关性分析.河北医科大学学报,2017,38(2):192-195.
[8] Smith HM,Farrow SJ,Ackerman JD,et al.Cardiac arrests associaled with hyperkalemia during red blood cell transfusion:a case serics.Anesth Analg,2008,106(4):1062-1069.
[9] Strauss RG.Date-driven blood banking practices for nconatal RBC transfusions.Transfusion,2000,40(12):1528-1540.
[10] 范娅涵,肖瑞卿,李兵,等.3种不同运输方式对红细胞悬液质量影响的实验研究.中国输血杂志,2008,21(8):577-580.
[11] 张婵,李琦,程瑜静,等.长途运输对滤白悬浮红细胞质量影响的研究.中国输血杂志,2015,28(11):1364-1366.
[12] 中国国家标准化管理委员会.全血及成分血质量要求.北京:中华人民共和国标准化管理委员会,2001:5.