体外模拟加压输血对悬浮红细胞质量影响的研究*

doi:10.3969/j.issn.1671-2587.2024.02.010

临床输血与检验 ›› 2024, Vol. 26 ›› Issue (2): 223-229.DOI: 10.3969/j.issn.1671-2587.2024.02.010

体外模拟加压输血对悬浮红细胞质量影响的研究^*

范瑞^1,4, 封春雨^2,3,4, 王雨婧^1,4, 尚玮玮^1,4, 唐文飞^1,4, 马海梅^1,4, 张欢^2,3,4

¹清华大学附属北京清华长庚医院输血科;
²清华大学附属北京清华长庚医院麻醉科;
³清华大学精准医学研究院;
⁴清华大学临床医学院北京 102218

收稿日期:2024-01-25 出版日期:2024-04-20 发布日期:2024-04-23
通讯作者: 马海梅,主要从事输血医学研究,（E-mail）mhm69@126.com。共同通信作者：张欢,主要从事围术期智能测控精准快速输注系统方面研究,（E-mail）whta01956@btch.edu.cn。
作者简介:范瑞,主要从事输血医学研究,（E-mail）fanrui028@163.com。并列第一作者简介：封春雨,主要从事麻醉学有关研究,（E-mail）1637162136@qq.com。
基金资助:
*本课题受清华大学精准医学科研项目（No. 20229990039）资助

Exploration of Effect on the Quality of Red Blood Cells Suspended during Pressurized Transfusion in Vitro Simulation

FAN Rui^1,4, FENG Chunyu^2,3,4, WANG Yujing^1,4, SHANG Weiwei^1,4, TANG Wenfei^1,4, MA Haimei^1,4, ZHANG Huan^2,3,4

¹Department of Blood Transfusion, Beijing Tsinghua Changgung Hospital;
²Department of Anesthesiology, Beijing Tsinghua Changgung Hospital;
³Institute for Precision Medicine, Tsinghua University;
⁴School of Clinical Medicine , Tsinghua University Beijing 102218

Received:2024-01-25 Online:2024-04-20 Published:2024-04-23

摘要/Abstract

摘要： 目的探讨不同压力对悬浮红细胞质量的影响,为研制加压输血装置提供数据支撑。方法将25袋悬浮红细胞随机等分成5组,分别施加10、20、30、40和50 Kpa压力,实时记录血流速度;施压前后分别留取部分血样测定红细胞相关指标（RBC、HGB、HCT、MCV、MCH、MCHC）变化情况,测定血浆中钾离子、间接胆红素、乳酸脱氢酶、游离血红蛋白含量;检测红细胞渗透脆性并用电镜观察红细胞形态变化,从而评价不同压力对血液质量的影响。结果加压可显著提高输血速度。在不同压力下红细胞相关指标变化与K⁺、IBIL、LDH变化无统计学意义,游离血红蛋白与溶血率均符合国家有关规定。电镜下观察随着压力升高出现少量异形红细胞,胞膜电子密度有差异,网状结构破坏,网眼不均匀。结论在50 Kpa范围内加压对红细胞损伤影响不大,血液质量符合我国相关标准要求。

关键词: 加压输血, 红细胞, 血液质量

Abstract: Objective To explore how various pressures affect the quality of red blood cells in suspension, and to offer data assistance for the creation of pressurized blood transfusion apparatus. Methods Five groups were randomly selected from the 25 bags of suspended erythrocytes, and pressures of 10, 20, 30, 40, and 50 Kpa were applied to each group respectively. The blood flow rate was recorded in real time. Before and after the pressure application, blood samples were obtained to look for changes in erythrocyte-related indices (RBC, HGB, HCT, MCV, MCH, MCHC). The content of potassium ion, indirect bilirubin, lactate dehydrogenase, and free haemoglobin in plasma were detected. The osmotic fragility was tested, and the morphology was observed. Finally, the effects of different pressures on blood quality were evaluated. Results The transfusion rate can be considerably raised by pressurization. The alterations in K⁺, IBIL, and LDH indices as well as erythrocyte-related indexes under various pressures did not show statistically significant changes. Free haemoglobin and haemolysis rate were in accordance with the national regulations. Certain heterogeneous erythrocytes with rising pressure, variations in the cytomembrane's electron density, disruption of the reticulum's structure, and reticulum inhomogeneity were seen using electron microscopy. Conclusion The brief duration pressure, within the range of 50 Kpa, does not significantly result in red blood cell destruction, and the blood quality can meet Chinese norms.

Key words: Pressurized blood transfusion, Red blood cells, Blood quality

中图分类号:

R457

范瑞, 封春雨, 王雨婧, 尚玮玮, 唐文飞, 马海梅, 张欢. 体外模拟加压输血对悬浮红细胞质量影响的研究^*[J]. 临床输血与检验, 2024, 26(2): 223-229.

FAN Rui, FENG Chunyu, WANG Yujing, SHANG Weiwei, TANG Wenfei, MA Haimei, ZHANG Huan. Exploration of Effect on the Quality of Red Blood Cells Suspended during Pressurized Transfusion in Vitro Simulation[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2024, 26(2): 223-229.

参考文献

[1] WAGNER T,PABST M A,LEITINGER G,et al.Impact of constant storage temperatures and multiple warming cycles on the quality of stored red blood cells[J].Vox Sang,2014,106(1):45-54.
[2] 中国医师协会急诊分会,中国人民解放军急救医学专业委员会,中国人民解放军重症医学专业委员会,等. 创伤失血性休克诊治中国急诊专家共识[J]. 临床急诊杂志,2017,18(12):881-889.
[3] KAUVAR D S,LEFERING R,WADE C E.Impact of hemorrhage on trauma outcome:an overview of epidemiology,clinical presentations,and therapeutic considerations[J]. J Trauma,2006,60(6 Suppl):S3-S11.
[4] GRUEN R L,BROHI K,SCHREIBER M,et al.Haemorrhage control in severely injured patients[J]. Lancet,2012,380(9847):1099-1108.
[5] 何娟明. 加压快速输液抢救失血性休克的疗效观察[J]. 实用医技杂志,2006,13(15):2697-2698.
[6] 刘峰,孙志勇.创伤合并失血性休克早期不同补液方式的急救效果观察[J].临床医药文献电子杂志,2019,6(22):16.
[7] DURFEY N,LEHNHOF B,BERGESON A,et al.Severe hyperkalemia:can the electrocardiogram risk stratify for short-term adverse events?[J]. West J Emerg Med,2017,18(5):963-971.
[8] PALMER B F,CLEGG D J.Diagnosis and treatment of hyperkalemia[J]. Cleve Clin J Med,2017,84(12):934-942.
[9] PIETROPAOLI A P,HENRICHS K F,CHOLETTE J M,et al.Total plasma heme concentration increases after red blood cell transfusion and predicts mortality in critically ill medical patients[J].Transfusion,2019,59(6):2007-2015.
[10] NAGY E,EATON J W,JENEY V,et al.Red cells,hemoglobin,heme,iron,and atherogenesis[J]. Arterioscler Thromb Vasc Biol,2010,30(7):1347-1353.
[11] 马印图,陈晓飞,王更银,等.加压输血对红细胞及血液质量影响的研究[J]. 临床血液学杂志,2020,33(8):566-569.
[12] 程金莲,李亚琴,孙玉梅.加压输注去白细胞全血过程中血红细胞及血钾变化的实验研究[J].护理研究,2014,28(1):27-30.
[13] 陈正琼. 两种加压器用于加压输血对红细胞破坏的比较研究[J] 护理研究,2004,18(23):2130.
[14] 国家质量监督检验检疫总局,中国国家标准化管理委员会.全血及成分血质量要求[S]. 2012.
[15] 张瑞君,段秉政,鞠春梅,等.储血袋的不同放置方式红细胞携氧指标的变化分析[J].重庆医学,2015,44(35):5001-5002.

体外模拟加压输血对悬浮红细胞质量影响的研究^*

Exploration of Effect on the Quality of Red Blood Cells Suspended during Pressurized Transfusion in Vitro Simulation

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

关于本刊

作者中心

在线期刊

访问统计

联系我们

[1]	中国输血协会临床输血管理学专业委员会. 术前深度单采自体红细胞和/或血小板储血技术应用中国专家共识[J]. 临床输血与检验, 2024, 26(2): 145-155.
[2]	葛晓芹, 付恒, 胡官林, 曹彩霞, 杨维涛, 王振兴, 周国琼, 付竹筠, 孙婧雯, 沈有华, 燕锋, 鲍琳, 林富文, 李丽, 王泽颖, 冯兰洁, 周竞, 康美艳, 张剑, 刘保霞, 汤文隽, 郭萍莉, 李浩, 邱艳. 新冠肺炎疫情对国内25家地级市中心血站全血制备成分血的供应影响分析^*[J]. 临床输血与检验, 2024, 26(2): 244-250.
[3]	李洋, 杨明峰, 王莹, 张坚, 刘嘉馨, 孙保亮. 血红蛋白类氧载体的研究进展及应用前景^*[J]. 临床输血与检验, 2024, 26(2): 282-288.
[4]	中国输血协会临床输血管理学专业委员会. 婴儿期输血前红细胞血型血清学检测中国专家共识^*[J]. 临床输血与检验, 2024, 26(1): 8-16.
[5]	杨晓樨, 赵营营, 马吉芳, 于政. 硅芯片纳米微流体技术与磁激活细胞分选法对胎儿有核红细胞富集效果的比较[J]. 临床输血与检验, 2024, 26(1): 86-91.
[6]	尤来委, 姚娜, 吴曼迪, 张岩, 崔应辉, 郭建荣. 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^*[J]. 临床输血与检验, 2023, 25(6): 721-726.
[7]	赵兴丹, 翁艾罕. 极低出生体重儿输血及输血量的影响因素及其预测模型构建[J]. 临床输血与检验, 2023, 25(6): 758-766.
[8]	冯娜, 兰静, 曹鑫, 丁谨, 景媛媛. X射线与γ射线辐照对悬浮红细胞质量影响的对比研究[J]. 临床输血与检验, 2023, 25(5): 594-598.
[9]	陈婷婷, 赵丽坤, 卓海龙, 骆群. ABO不同血型在不同保存期内CD38的表达[J]. 临床输血与检验, 2023, 25(5): 613-618.
[10]	付晓艳, 甄自达, 邱立娟, 张慧敏, 王孟键, 马曙轩. 红细胞储存时间与体外循环心脏手术患儿术后急性肾损伤的关系[J]. 临床输血与检验, 2023, 25(4): 489-493.
[11]	张静, 王素玲, 乔芳, 赵佳, 胡光磊, 王振雷. NEC患儿T抗原暴露导致红细胞多凝集现象的鉴定及输血策略[J]. 临床输血与检验, 2023, 25(4): 494-497.
[12]	陈婷婷, 卓海龙, 刘慧, 王道琳, 骆群. 改良法制备冰冻解冻去甘油红细胞初步应用研究[J]. 临床输血与检验, 2023, 25(4): 498-502.
[13]	刘慧, 卓海龙, 王道琳, 陈婷婷, 骆群. 改良法在制备冰冻红细胞技术上的应用研究[J]. 临床输血与检验, 2023, 25(3): 315-319.
[14]	陈怡静, 卓海龙, 张怡, 程晨, 骆群. X射线辐照对淋巴细胞的灭活能力及对悬浮红细胞质量的影响研究[J]. 临床输血与检验, 2023, 25(3): 320-323.
[15]	邓桂花, 龙馨妍, 孙亚纯, 王雷萍, 张传国, 孟庆宝. 智慧型输血医学科的建设[J]. 临床输血与检验, 2023, 25(2): 185-189.