用原子力显微镜观察术中失血回收对红细胞形态的影响

目的: 采用原子力显微镜(AFM)观察术中失血回收对红细胞外貌及膜超微结构的影响。方法: 择期脊柱手术患者,术中应用自体血液回收机,切皮前采集外周静脉血2 mL(T1),洗涤前血液2 mL(T2),洗涤后血液2 mL(T3),回输洗涤血1 h后外周静脉血2 mL(T4),肝素抗凝。采用荧光正置显微镜观察红细胞畸形率及AFM观察红细胞膜表面超微结构。结果: T1时刻红细胞畸形率 低于T2 、T3 和T4 (P<0.05),而后三者红细胞畸形率并无显著差异。回收血和静脉血红细胞AFM形貌、红细胞膜表面蛋白颗粒分布均存在显著差异。T2红细胞膜表面平均粗糙度、均方根粗糙度高于其它时点收集的红细胞(P<0.05)。结论: 术中自体血液回收可增加红细胞畸形率,改变红细胞AFM形貌及膜表面超微结构 。

Effect of intraoperative blood salvage on erythrocyte morphosis observed under atomic force microscope

AIM: To investigate the effect of intraoperative blood salvage(IOBS) on the morphosis of erythrocytes with atomic force microscopic(AFM) observation.METHODS: Blood samples from the patients with spinal operation were collected before operation(T1) and 1 h after IOBS(T4).Unprocessed blood(T2) and processed blood(T3) in the cell saver were also measured.An AFM with nanometer resolution was used to examine the ultrastructure of membrane surface of the erythrocytes in the samples.RESULTS: The percentage of heteromorphous erythrocytes in T1 samples was the lowest.There were significant differences in AFM images and height profile of a single erythrocyte between salvaged blood and venous blood.AFM images at 1 μm range showed that the distribution of the particles on the erythrocyte membrane surface in unprocessed blood in cell saver was significantly different from the other blood samples.CONCLUSION: There are significant changes in the AFM images of erythrocytes and the ultrastructure of the membrane surface in salvaged blood.