不同保存期全血制备洗涤红细胞的超微结构变化

目的 探讨不同保存期的全血制备洗涤红细胞前后电镜下红细胞形态的变化。方法 采集CPD—A抗凝全血。实验分Ⅰ～Ⅵ组，分别于4℃保存7、10、15、20、25、30d。于制备前取全血1滴，5％戊二醛固定，经2000r／min离心10min后，分出血浆，取样检测血红蛋白。余下的红细胞再加等量生理盐水，1500r／min离心5min，连续2次，取样为制备后测定组。结果 组Ⅰ和组Ⅱ制备前后红细胞成双面凹的圆盘结构，细胞均匀混悬。组Ⅲ制备前红细胞形态正常，制备后少数红细胞出现聚集状、球形或边缘不整齐，并有棘形红细胞出现。组Ⅳ、组Ⅴ、组Ⅵ于制备前血浆微红；制备后，球形红细胞、棘形红细胞、中问漏孔的红细胞增加。结论 制备洗涤红细胞的最佳时间应在4℃保存10d内的全血，保存15d以后的全血制备洗涤红细胞形态发生异常变化，出现棘形红细胞，囊泡化后的红细胞易溶血，红细胞寿命缩短，影响洗涤红细胞的质量。     

The cost of allogeneic red blood cells – a systematic review

Summary.  Several reports suggest that the cost of RBCs may have risen over time, but there exists very little published evidence of that. The objective was to determine whether published studies documenting cost data on RBCs suggest an increase over time and to assess the quality of cost studies. We used the terms 'cost', 'allogeneic/allogenic' and 'blood' to identify cost studies between 1966 and 2002 from Medline, ISIesource and Ingenta electronic databases. Furthermore, we manually searched a number of transfusion and health economics journals for completeness. We included studies that used an established methodology and conducted an economic evaluation using primary/secondary cost data to calculate the cost of RBCs and RBC transfusion. Studies without allogeneic RBCs as comparator were excluded. Two individuals independently reviewed the studies and included studies upon reaching a consensus. Fourteen studies qualified the selection criteria and were included in the review. Ten studies were identified from Medline, two from Ingenta, one from ISIesource and one was a conference paper. Of the 14 studies reviewed, 10 had focused on RBC transfusion and four had focused on both RBCs and RBC transfusion. Ten studies were from the US, and two each from Canada and the UK, respectively. Two studies had explicit objective of cost calculation, and others had calculated costs towards fulfilling other objectives. Most of the reviewed studies were dated and of poor quality. Despite these limitations, it appears that the cost of RBCs has increased over time in the UK, Canada and the US. More studies are needed to fully assess the trend of costs over time. Future cost studies should try to follow the economic evaluation guidelines for greater research implications.     

mPEG修饰红细胞Rh抗原稳定性的研究

本研究旨在探究mPEG修饰的红细胞Rh抗原的稳定性。利用红细胞膜蛋白SDS—PAGE电泳技术分析mPEG修饰后红细胞膜蛋白与mPEG结合情况，用红细胞血影凝集实验及40cCPD保养液保存的修饰红细胞与匹配血液体外混血实验，观察mPEG修饰后红细胞Rh抗原被遮蔽的稳定性。结果发现：不同保存时间的mPEG修饰的红细胞在模拟输血（即混血前后）的血型保持不变，同时mPEG修饰的红细胞在保存过程中游离血红蛋白水平正常，并且混血后经37℃孵育的mPEG修饰的红细胞游离血红蛋白水平低于不混合的修饰的红细胞。比较分析PEG特异的碘染和考马斯亮蓝染的显色图谱发现，特殊的碘染显示出mPEG与红细胞膜蛋白结合的条带，mPEG—SPA与红细胞膜蛋白结合后导致蛋白分子迁移速度发生改变。mPEG修饰的红细胞血影凝集实验证实，修饰红细胞在质膜裂损后mPEG仍有效地遮蔽抗原。结论：mPEG—SPA不论在红细胞膜蛋白被单独提取后，还是膜破损后以及存活状态下，均能与红细胞膜蛋白稳固结合。     

甘油浓度对红细胞冻干保存效果的影响

目的探讨甘油浓度浓度对红细胞冷冻干燥保存的回收率、溶血率及残余水含量的关系。方法以甘油浓度分别为3%、6%、9%、12%、15%、18%、21%(w/v)的冻干保护剂处理红细胞,冻干,用显微镜观察细胞形态、血细胞计数仪检测细胞数、分光光度计测定游离血红蛋白量,分析细胞复水后红细胞计数、溶血情况。用热重法测定冻干红细胞水分含量,分析不同保护剂组红细胞的水分含量变化情况。结果复水后红细胞形态正常,甘油浓度为9%、12%、15%时,红细胞回收率分别为(77.08±9.41)%、(84.37±3.42)%、(80.21±9.20)%,红细胞溶血率分别为(19.82±2.23)%、(17.66±1.17)%、(15.86±2.23)%,相应的冻干红细胞残余水分含量为(19.43±1.36)%、(22.89±1.57)%、(26.17±1.09)%。结论保护剂中甘油浓度影响红细胞冻干保存的效果;甘油浓度为(9-15)%时对冻干保存的红细胞损伤较小;冻干红细胞残余水分含量随保护剂中甘油浓度的增高而增高。     

聚乙二醇衍生物修饰红细胞的保存性能研究

目的 评估经甲氧基聚乙二醇-琥珀酰亚胺丙酸酯(mPEG-SPA)修饰后红细胞(RBC)的保存性能.方法 以mPEG-SPA体外修饰健康人RBC;观察修饰前后RBC的变形性、渗透脆性、自身溶血率、磷脂酰丝氨酸和CD59,评估修饰对RBC保存性能的影响.结果 mPEG-SPA修饰后RBC的变形性略有下降、渗透脆性和自身溶血率有所增加;修饰后红细胞磷脂酰丝氨酸表达明显增加;红细胞CD59的表达严重下降,其表达率几近于零.结论 mPEG-SPA修饰后红细胞的保存性能下降,可能影响修饰后红细胞的寿命和输入体内的存活率.     

经辐射处理离体血在保存期内红细胞与血小板参数的变化

目的 研究不同剂量＾６０Ｃｏ－γ射线辐照离体血后在保存期内对红细胞与血小板诸参数的影响。方法 应用＾６０Ｃｏ－γ射线单次均匀照射,总剂量分别为１５、２０、２５、３０和３５Ｇｙ。应用ＳｙｓｍｅｘＦ－８００血液分析仪测定照射前后及保存第３、７、１４和２１天红细胞诸参数,包括血红蛋白（Ｈｂ）、红细胞（ＲＢＣ）、红细胞平均容量（ＭＣＶ）、红细胞比积（ＨＣＴ）、红细胞分布宽度（ＲＤＷ）;以及血小板诸参数,包     

血细胞分析仪对外周血有核红细胞计数性能的评价

目的评价Sysmex XE-2100血细胞分析仪计数外周血有核红细胞（NRBC）的性能。方法选择门诊与住院患者乙二胺四乙酸二钾抗凝血标本,采用Sysmex XE-2100血细胞分析仪与手工显微镜方法计数NRBC,并对结果进行比较。结果血细胞分析仪与手工显微镜方法之间相关性良好,相关系数为0.938 4;58份标本仪器法NRBC在0.00%～0.99%标本中14份（24.1%）手工法NRBC结果为0.00%。24份仪器法NRBC结果为0.00%的标本中22份（91.2%）手工法小于或等于1.00%;仪器法重复性明显好于手工法,NRBC平均CV为8.0%。结论 Sysmex XE-2100血细胞分析仪与手工显微镜法之间相关性较好;仪器法重复性明显好于手工法;尽管出现少量仪器法与镜检法不一致结果,但均伴有其他白细胞和（或）血小板异常报警提示,也进行了显微镜复核。     

Peripheral blood stem cell collection in a patient with chronic myelogenous leukemia and a high circulating nucleated red cell fraction

A high level of circulating nucleated red blood cells (NRBC) in patients with chronic myeloproliferative syndromes could potentially complicate peripheral blood stem cell (PSC) collection. The mononuclear NRBC might comprise a significant fraction of the total mononuclear cells in the final product. We report a successful PSC collection in a patient with more NRBC than WBC in the peripheral blood. A 27-year-old man with chronic myelogenous leukemia underwent eight PSC collection procedures, seven using the Cobe Spectra (Spectra) and one using the Fenwal CS3000 Plus (CS). PSC product manipulations to remove NRBC were unnecessary. As assessed by post-collection NRBC:WBC ratio as a percent of the initial ratio, Spectra selectively harvested mononuclear leukocytes over NRBC. The collected products had a mean NRBC:WBC ratio that was 3.4% of the peripheral blood ratio. Adequate numbers of mononuclear leukocytes were collected with less than 6% NRBC contamination. The single CS procedure resulted in a comparable NRBC reduction efficiency as the Spectra. We conclude that PSC harvest using automated blood cell separators from patients with a high level of circulating NRBC may result in a product with an acceptable number of NRBC.     

Using redox potential as a feasible marker for banked blood quality and the state of oxidative stress in stored red blood cells

BackgroundStored red blood cells (RBCs) may undergo oxidative stress over time, with functional changes affecting oxygen delivery. Central to these changes are oxidation‐reduction (redox) reactions and redox potential (RP) that must be maintained for cell function. RP imbalance can lead to oxidative stress that may contribute to storage lesions. This study''s purpose was to identify changes in RP over time in banked RBCs, and among RBCs of similar age.MethodsMultiple random RBC segments from RBC units were tested (n = 32), ranging in age from 5 to 40 days, at 5‐day intervals. RP was recorded by measuring open circuit potential of RBCs using nanoporous gold electrodes with Ag/AgCl reference. RP measures were also performed on peripheral venous blood from 10 healthy volunteers. RP measures were compared between RBC groups, and with volunteer blood.ResultsStored RBCs show time‐dependent RP increases. There were significant differences in Day 5 RP compared to all other groups (p ≤ 0.005), Day 10–15 vs. ages ≥ Day 20 (p ≤ 0.025), Day 20–25 vs. Day 40 (p = 0.039), and all groups compared to healthy volunteers. RP became more positive over time suggesting ongoing oxidation as RBCs age; however, storage time alone was not predictive of RP measured in a particular unit/segment.ConclusionsThere are significant differences in RP between freshly stored RBCs and all others, with RP becoming more positive over time. However, storage time alone does not predict RP, indicating RP screening may be an important measure of RBC oxidative stress and serve as an RBC quality marker.     

MAP洗涤红细胞再冰冻的实验研究

目的对红细胞洗涤后冰冻保存的安全性探讨。方法选择20袋(2u/袋)悬浮红细胞,每袋分成2份(1u/份)为实验组和对照组,实验组制备成M AP洗涤红细胞后再冰冻保存;对照组直接制备成冰冻红细胞,一周后实验组和对照组用同等方法进行去甘油解冻,并计算红细胞的回收率及其相关质控指标。结果实验组和对照组冰冻红细胞回收率,甘油残余量,上清液游离血红蛋白含量及体外溶血率比较无显著性差异(P>0.05),两组成品无菌试验均阴性。结论M AP洗涤红细胞制备成冰冻红细胞,各项质量指标符合国家标准,能应用于临床,因而有效解决临床备用洗涤红细胞剩余而造成的血液浪费。     

XE-5000血细胞分析仪计数有核红细胞的性能评价

目的探讨SysmexXE．5000血细胞分析仪自动计数外周血有核红细胞（NRBC）的方法学特点,评价其临床应用价值。方法评析其重复性、线性范围、携带污染率,并对697份静脉血标本作常规测定,评价其对NRBC的报警、定量测定,并与手工涂片法进行对照。结果XE．5000血液分析仪测定NRBC的重复性较好,线性范围较广,携带污染率较小。以显微镜复检为金标准,XE．5000与显微镜计数法计数外周血中NRBC数量有极好的相关性（r=0．997）,其有核红细胞报警的灵敏度为100％,特异度为85．1％。结论SysmexXE．5000血细胞分析仪可灵敏、准确、精密地自动计数外周血中NRBC,适合临床检测NRBC。     

冻干红细胞胞膜CD分子的检测与分析

目的 探讨红细胞胞膜CD分子在冻干前、后的变化。方法 使用流式细胞术(flow cytometry,FCM)检测冻干前、后红细胞胞膜CD35、CD44、CD45、CD47和CD71分子数量。结果 冷冻前、冻于复水洗涤后红细胞胞膜CD35、CD44、CD45、CD47和CD71分子数量的差异不存在统计学意义(P＞0...     

Blood group antigens defined by the amino acid sequences of red cell surface proteins

SUMMARY. The antigens of 18 blood group systems are expressed on proteins that are intrinsic to the red cell. The proteins which carry the antigens of these systems have been identified and primary sequence information is available for all but two (SC, DO). Several different functional groups are evident. Antigens of the DI, CO, RH, XK and JK systems are located on proteins which have the structure of membrane transport proteins. The FY antigens mark a cytokine receptor. The IN, LW, XG antigens are associated with molecules which have adhesion functions and the LU glycoprotein also has a structure which suggests a role in adhesion. YT and KEL antigens are located on cell surface enzymes and the CR and KN antigens on molecules involved in complement regulation. Finally, the MN and GE antigens are located on sialic acid-rich glycoproteins (glycophorins A, B and C/D respectively), a group of molecules which do not, as yet, have a clearly defined function. The molecular basis of antigens in several blood group systems have been defined and shown to depend upon the amino acid sequence.     

新生儿硬肿症血液流变特性及其意义的研究

新生儿硬肿症是由受寒、早产、感染、室息等多种原因引起的皮肤和皮下脂肪硬化与水肿的一种疾病．国内自70年代早期开始对新生儿低体温和硬肿症的病理生理与治．做了大量的研究工作、使其病死率有所降低，但迄今其仍为威胁新生儿健康和生命的严重疾病之一。本文研究目的在于阐述血液流变特性异常是新生儿疗硬肿症发病机理之一．为采用血液流变学治疗方法提供理论参考。     

25～45Gyγ射线辐照对红细胞制品质量的影响

目的　研究不同剂量辐照对红细胞的活性及功能的即刻损伤及保存损伤 ,确定辐照血液的保存时间。方法　将CPDA 全血 4 0 0ml分成 4组 ,于采血后 1d进行 0 (为对照组 )、2 5、35、4 5Gyγ射线辐照。在辐照后 0、4、7、1 4、2 1、2 8、35d取样测定红细胞活性、功能指标。结果　 0～ 35d保存过程中 ,①红细胞功能 :各辐照组的 2 ,3 DPG含量与对照组比较均无显著性差异 (P >0 .0 5 ) ;②红细胞活性 (ATP含量 ) :2 5Gy辐照组在 35d保存过程中与对照组差异无显著性 (P >0 .0 5 ) ;35、4 5Gy组分别于 35d(84 .7% )及 2 8d(83.6 % )起低于对照组 (P <0 .0 5 ) ;③红细胞脆性 :红细胞最小抵抗力 ,2 5、35、4 5Gy组分别自 35、2 8、2 1d起低于对照组 (P <0 .0 5 ) ;红细胞最大抵抗力 ,保存过程中 2 5Gy组与对照组差异无显著性 (P >0 0 5 ,35、4 5Gy组分别自 35及 1 4d起低于对照组 (P <0 .0 5 ) ;④游离K+ :2 5Gy组自辐照后 1d ,35、4 5Gy组自辐照后 0d起即高于对照组 (P <0 .0 5 ) ;K+ 含量与剂量呈正相关性 (r为 0 .96 6～ 0 .999) ;⑤游离血红蛋白 :在保存过程中显示出一定的剂量关系 ,但差异尚无统计学意义。结论　辐照对红细胞有一定的损伤 ,损伤程度与剂量有一定的相关性 ,但总体来说损伤不大 ,对红细胞活性