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临床输血与检验

临床输血与检验 ›› 2023, Vol. 25 ›› Issue (1): 88-96.DOI: 10.3969/j.issn.1671-2587.2023.01.015

• 基础研究 • 上一篇    下一篇

清开灵注射液保存血小板对体外大失血模型的纠正效果*

李洁, 张雪睿, 陈忠如, 陈荣华, 兰炯采   

  1. 536000 广西北海市人民医院输血科（李洁,张雪睿,陈荣华）,北海市中心血站（陈忠如）,南方医科大学南方医院（兰炯采）
  • 收稿日期:2022-11-08 发布日期:2023-02-20
  • 通讯作者: 张雪睿,女,副主任医师,研究生,主要从事儿童输血研究,（E-mail）zhxr2007@126.com。共同通信作者：兰炯采,男,研究员,博士研究生导师,主要从事免疫血液学研究,（E-mail）gzlanjc@hotmail.com。
  • 作者简介:李洁（1993-）,女,主要从事临床输血与检验研究,（E-mail）1479006874@qq.com。
  • 基金资助:
    *本课题受广西壮族自治区北海市科技局项目（No.2019C05）资助

Correction Effect of Platelets Preserved with Qingkailing Injections in Vitro Model of Massive Blood Loss

LI Jie, ZHANG Xue-rui, CHEN Zhong-ru, et al   

  1. Department of Transfusion Medicine ,Beihai People's Hospital ,Beihai 536000
  • Received:2022-11-08 Published:2023-02-20

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摘要： 目的 探讨清开灵注射液保存血小板对体外大失血模型的纠正效果。方法 取机采血小板8（人）份（≥250 mL/份）,每份等分成2×125 mL;添加终浓度为1%清开灵注射液约1.25 mL/份作为实验组22℃振荡保存;同时设对照组：取与实验组等量（份）机采血小板,不加清开灵注射液,同样保存条件。采用血液稀释法（全血:生理盐水=1:9）制备体外大失血模型,应用血栓弹力图（thrombelastography,TEG）检测指标及血常规指标对比、研究去白细胞悬浮红细胞、新鲜冰冻血浆（fresh frozen plasma, FFP）与清开灵注射液保存血小板（简称实验组血小板）或对照组血小板按1:1:1比例对体外大失血模型的纠正效果。结果 血小板保存至1、3、5 d时,实验组和对照组血小板在对相同血样制备的体外大失血模型进行纠正,PLT（×109/L）从19~20分别升至68~72 vs. 57~64（P<0.05）,TEG-MA值（mm）由9.6 ~11.4分别升至49.1~58.3 vs. 48.1~55.1（P<0.05）,TEG-R值（min）由7.1~8.2降至3.9~4.6 vs. 3.7~4.0（P>0.05）;保存7~14 d,实验血小板组：PLT（×109/L）从18纠正至56~62,TEG-MA值（mm）由10.4~12.1纠正至43.3~47.9,TEG-R值（min）由8.2 ~ 8.9纠正至3.6~5.5（P<0.05）。结论 去白细胞悬浮红细胞、新鲜冰冻血浆和清开灵注射液保存血小板能够纠正体外大失血模型,提示清开灵注射液保存10 d的血小板具有纠正效果。

关键词: 清开灵注射液, 血小板, 大失血模型, 失血纠正, 止血

Abstract: Objective To investigate the effect of Qingkailing injections on in vitro model of massive blood loss. Methods Eight apheresis platelets (≥250 mL / sample) collected were equally divided into 2×125 mL. A final concentration of 1% Qingkailing injections (1.25 mL in 125 mL) as the experimental group was stored at 22℃ with constant shaking. The control group did not add Qingkailing injections. The model of massive blood loss in vitro was established by blood dilution method (whole blood:saline =1:9). The thrombelastography（TEG）indexes and blood routine indexes were compared to discuss the correction effect of leukocyte-reduced red blood cells (RBCs), fresh frozen plasma (FFP) and platelets with or without Qingkailing injections in a 1:1:1 ratio on in vitro model of massive blood loss. Results After platelets were stored for 1, 3, and 5 days, Platelets (×109/L) in the experimental group and the control group increased from 19~20 to 68~72 vs. 57~64 (P<0.05), respectively. The TEG-MA value (mm) increased from 9.6~11.4 to 49.1~58.3 vs. 48.1~55.1 (P<0.05), however the TEG-R value (min) decreased from 7.1~8.2 to 3.9~4.6 vs. 3.7~4.0 (P>0.05). After 7~14 days, platelets (×109/L) were corrected from 18 to 56~62, TEG-MA value (mm) from 10.4~12.1 to 43.3~47.9, and TEG-R value (min) was corrected from 8.2~8.9 to 3.6~5.5 (P<0.05). Conclusion In vitro model of massive blood loss could be corrected by leukocyte-reduced red blood cells, fresh frozen plasma and platelets preserved with Qingkailing injections, suggesting that platelets stored for 10 days with Qingkailing injections had a correction effect.

Key words: Qingkailing injections, Platelet, Massive blood loss model, Correction of blood loss, Hemostasis

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