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临床输血与检验

临床输血与检验 ›› 2023, Vol. 25 ›› Issue (6): 721-726.DOI: 10.3969/j.issn.1671-2587.2023.06.001

• 基础研究 •    下一篇

不同配方保存液对2型糖尿病患者贮存式自体红细胞保护作用的对比研究*

尤来委, 姚娜, 吴曼迪, 张岩, 崔应辉, 郭建荣   

  1. 海军军医大学附属公利医院麻醉科, 上海 200135
  • 收稿日期:2023-09-26 出版日期:2023-12-20 发布日期:2024-01-15
  • 通讯作者: 郭建荣,主要从事围术期输血与血液保护研究,（E-mail）jianrguo@126.com。
  • 作者简介:尤来委,主要从事围术期输血与血液保护研究,（E-mail）youlaiwei@126.com。
  • 基金资助:
    *本课题受新兴、交叉学科建设项目附带课题（No.PWXx2020-05）、重点学科群附带主攻课题（No.PWZxq2022-05）资助

Comparative Study on the Protective Effect of Different Preservation Solutions on Red Blood Cell Storage Lesion in Type 2 Diabetes Mellitus

YOU Laiwei, YAO Na, WU Mandi, et al   

  1. Department of Anesthesiology, Gongli Hospital, Naval Military Medical University, Shanghai 200135
  • Received:2023-09-26 Online:2023-12-20 Published:2024-01-15

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摘要： 目的 本研究旨在探讨不同配方保存液对体外贮存期红细胞损伤的影响,以提供2型糖尿病（T2DM）患者红细胞适宜贮存条件。方法 收集2021年6月—2022年1月择期手术的糖尿病患者和非糖尿病患者各20例。糖尿病患者红细胞分别储存于不同配方保存液中（保存液a、保存液b和保存液c）以筛选出适宜保存液（DO-o）,观测非糖尿病患者常规保存液组（NC组）、糖尿病患者常规保存液组（DO-c组）和糖尿病患者新型保存液组（DO-o组）中,红细胞的形态结构和功能代谢的变化。结果 在T0（红细胞分离后即刻）、T1（贮存7天）、T2（贮存14天）、T3（贮存21天）和T4（贮存28天）时,各组内红细胞计数、血红蛋白（Hemoglobin,Hb）、Na+和pH值逐渐降低（P<0.05）,K+浓度逐渐增高（P<0.05）。保存液b中红细胞计数明显多于a和c组（P<0.05）,T2、T3和T4时,保存液a和b组Hb量高于c组（P<0.05）; T3和T4时,保存液b组中Na+浓度高于另外两组（P<0.05）;T2、T3和T4时,保存液a组和c组中K+浓度高于b组（P<0.05）。在各个时间点,溶血率、游离血红蛋白（FHb）、乳酸（LA）、乳酸脱氢酶（LDH）在各组内和组间差异具有统计学意义（P<0.05）。在各时间点,DO-o组溶血率、FHb、LA和LDH低于DO-c组（P<0.05）;各组内ATP逐渐降低,差异有统计学意义（P<0.05）,T1、T2和T4时,DO-o组ATP高于DO-c组（P<0.05）。结论 新型保存液可以显著改善T2DM患者红细胞贮存损伤。

关键词: 新型保存液, 2型糖尿病, 红细胞贮存损伤, 酸碱度, 氯化钠, 葡萄糖

Abstract: Objective To investigate the effects of different formulas of red blood cell (RBC) preservation solutions on RBC storage lesions in vitro to provide optimal storage solution for RBC in patients with type 2 diabetes mellitus (T2DM). Methods A total of 20 diabetic patients and 20 non-diabetic patients who underwent elective surgery from June 2021 to January 2022 were collected. RBCs were stored in different preservation solutions (preservation solution a, preservation solution b and preservation solution c) to select out the appropriate preservation solution (DO-o). Morphologic and metabolic changes in RBCs were observed in the conventional preservation solution of non-diabetic patient group (NC group), the conventional preservation solution and the new preservation solution of diabetic patient group (DO-c group and DO-o group). Results At T0 (immediately after red blood cell separation), T1 (storage for 7 days), T2 (storage for 14 days), T3 (storage for 21 days) and T4 (storage for 28 days),RBC count, hemoglobin, Na+ concentration and pH value in each group gradually decreased (P<0.05), while K+ concentration gradually increased (P<0.05). The RBC count in preservation solution group b was significantly higher than that in group a and c (P<0.05). At T2, T3 and T4, the levels of hemoglobin in group a and b were higher than that in group c (P<0.05). At T3 and T4, Na+ in group b was higher than that in the other two groups (P<0.05). At T2, T3 and T4, K+ in group a and c was lower than that in group b (P<0.05). At each time, there were statistically significant differences in hemolysis rate, Free Hemoglobin (FHb), Lactic Acid (LA) and Lactate Dehydrogenases (LDH) within and between groups (P<0.05); the hemolysis rate, FHb, LA and LDH were significantly lower than those in the DO-c group (P<0.05). Adenosine Triphosphate(ATP) in all groups gradually decreased, and the difference was statistically significant (P<0.05); at T1, T2 and T4, ATP in DO-o group was higher than that in DO-c group (P<0.05). Conclusion The new preservation solution can significantly improve RBC storage lesions in diabetic patients.

Key words: New preservation solution, Type 2 diabetes, Red blood cell storage lesions, pH, NaCl, Glucose

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