术中自体血液回收对电镜下红细胞形态及膜蛋白二级结构的影响

目的探讨术中回收的自体血红细胞质量。方法选取全麻下行择期脊柱手术同时行术中自体血回收的患者30名,术中取患者术野活动性出血及经血液回收机回收处理后的浓缩红细胞,同时另取库存9~15d采用CPDA保养液保存的去白细胞浓缩红细胞悬液各30份。在扫描电子显微镜下观察红细胞形态,计算异常形态红细胞的百分比;采用傅立叶变换红外光谱检测红细胞膜蛋白的二级结构。结果回收血异常形态红细胞的百分比均低于术野血和库存血红细胞。3组间红细胞膜蛋白α-螺旋结构吸光度的差异均无显著性。结论扫描电子显微镜观察下回收自体血红细胞的形态优于术野血及库存血红细胞;膜蛋白的二级结构不是造成红细胞形态差异的主要原因。

Effect of intra-operative autotransfusion on erythrocyte morphosis observed by electronmicroscope and membrane protein secondary structure

Objective To study the effect of intra-operative autotransfusion (IAT) on the erythrocyte morphosis and red blood cell membrane protein secondary structure. Methods Thirty ASA II～III patients, who underwent elective spinal operation under general anesthesia, were selected for IAT. RBCs collected from the operative field (Group S) and those after cell saver processing (Group H), were compared with the CPDA-preserved, 9-15 day storage RBCs (Group K) for erythrocyte ultrastructure, percent of nondisk shaped red cells, and erythrocyte membrane protein secondary structure, by electron microscope and Infrared Spectra. Results The percentage of nondisck shaped red cells of Group H was the lowest, and Infrared Spectra examination showsed no significant difference among the three groups. Conclusions The cell saver processed erythrocytes are superior in morphosis as observed by electron microscope.