手工洗涤血小板制备及临床输注后疗效探究.docVIP

手工洗涤血小板制备及临床输注后疗效探究 　【摘要】 目的 对比研究手工洗涤后血小板功能与形态的影响，观察洗涤血小板的质量和临床疗效。方法 采用血细胞分析、经典玻球法、经典比浊法、对CS 3000plus血细胞分离机采集血小板和手工制备洗涤血小板相互间的有关形态指标、黏附聚集性的比较，双盲法输注机采血小板和手工洗涤血小板。结果 手工洗涤血小板的回收率可达洗涤前的91.08%，残余红细胞(0.315±0.003)×109/u，残余白细胞(0.032±0.003)×108/u，血浆蛋白清除率≥99.14%，与机采血小板差异有统计学意义（Plt;0.01）。两组制品血小板PDW和MPV、血小板的黏附聚集率、血小板功能的指标与机采血小板差异无统计学意义（P＞0.05）。洗涤血小板临床输注后疗效与机采血小板差异无统计学意义（P＞0.05），且输注不良反应明显低于机采血小板。结论 利用0.9%的生理盐水对血小板进行手工洗涤的工艺方法是科学的、可行的，洗涤血小板各项质量指标符合国家标准，在临床的应用有广阔的前景。 【关键词】 血小板；洗涤；机采/CS 3000；临床应用 【Abstract】 Objective To assess the influence of apheresis and wash on platelet function and morphology.Washed platelet of quality and clinical effect were observed.Methods To determine the count，size，distribution，aggregation of the platelet from the peripheral blood prior to apheresis and aphersed produced by CS 3000 plus or washed platelets，double blindness transport the peripheral blood prior to apheresis and aphersed produced by CS 3000 plus and washed platelet.Results Washed platelet recycle rate 91.08%，residul WBC( 0.032±0.003)×108/u，residul RBC (0.315±0.003)×109/u，plasma protein separate ≥99.14%，both apheresed and washed platelet showed no problem on PDW and MPV，there were no statistical difference between groups.There were no difference in platelet and aggregation expression（P＞0.05）.But there is no difference between apheresed and washed platelet.Clinical observation of efffects no diffence（P＞0.05）.In addition it is improving blood safety.Conclusion 0.9%GNS washed platelet was science and safety.Quality of washed platelet fit into country’s standard，washed platelet have reliable quality and can be used in a variety of clinical conditions and new preservation technique. 【Key words】 platelet;flow-cytometry;CS 30000;clinical application 随着血细胞分离机在国内的推广，我国机采血小板的用量逐年攀升，已占了临床应用血小板的绝大部分［1，2］。影响血小板输注疗效的，包括是非免疫因素和免疫因素［3］。目前国内用CS 3000plus血细胞分离机及专用的配套管道洗涤血小板，成本大，手工采集血小板洗涤报道很少；本文就手工采集血小板洗涤制备的安全性与临床疗效进行研究，报道如下。 1 材料与方法 1.1 材料 采集全血400ml多联袋和机采血小板耗材(南格尔公司)。 1.2 设备 大容量低温离心机(J-6M型，美国Bec