新型血小板制剂的研究现状

近 2 0多年来 ,虽然血小板的分离和保存方法有了较大改进 ,但仍有一些难以克服的缺点 ,尤其是保存期短 ,供应短缺经常发生 ,为此发明了多种新的保存方法 ,也研发了多种代用品。血小板代用品目前多处于实验阶段或临床前研究阶段 ,下面就新型血小板制剂 (表 1)的研究现状做一综述。表 1　新型血小板制剂种类研究现状冰冻血小板已临床应用低温保存液态血小板临床前期研究光化学处理血小板Ⅲ期临床试验血小板源性膜微粒Ⅱ期临床试验冻干血小板临床前期研究去除HLA血小板早期临床试验1　冰冻血小板除了传统液体浓缩血小板 ,冰冻血小板已在国内…     

高血小板浓度在采集和冷冻干浓缩血小板中的影响

采用5％或6％二甲基亚砜(DMSO)冷冻保存血小板是浓缩血小板(PC)长期保存的最佳方法，这个浓度的DMSO对血小板没有毒性。虽然冷冻和融化过程由于血小板膜完整性丧失，引起血小板激活和细胞溶解，但冷冻保存血小板能被安全地输注，其止血功能优于22C保存5天的PC，且回收率相似。     

手工法和机器单采法浓缩血小板的制备及质控结果分析

目的　观察机采血小板与手工血小板之间的质量差异。方法　分别对机器单采血小板和手工血小板进行质控检测 ,结果　手工法血小板不合格 73袋 ,不合格率为 6 6 .36 % ;机器单采法血小板不合格 4袋 ,不合格率为5 .2 % ,两者之间有显著性差异 (P <0 .0 1 )。结论　机器单采血小板质量明显优于手工血小板     

连接管串联输液电解质浓度及张力变化的研究

目的观察连接管串联方式输液过程中液体浓度及张力的变化。方法采用连接管串联输液方式,体外模拟输注1/2张含钾0.3%的混合液1 000 ml,测定不同时段滴注液体中Na 、K 、Cl-浓度并计算张力。结果各瓶液体随输注时间推移逐渐混合,电解质浓度及液体张力亦随之改变。结论临床静脉输液要注意正确使用连接管串联方式。     

-80℃保存机采浓缩血小板的实验研究

血小板在成分输血中的地位已越来越重要 ,输注比例正逐年显著提高 ,血小板的体外保存也因此成为国内外输血医学的研究热点 [1 ,2 ]。笔者用两年多的时间对 -80℃保存机采浓缩血小板 (以下简称冰冻血小板 )进行了较深入的实验研究 ,比较了不同保存时期冰冻血小板的功能及回收率 ,现将实验结果报告如下。材料与方法1　主要仪器设备　 CS-3 0 0 0 Plus血细胞分离机 ;TYXN-91 A智能血液凝集仪 ;F-82 0血细胞计数仪 ;局部 1 0 0级净化间 ;-80℃深低温冰箱。2　冰冻血小板的制备、保存与解冻　选择符合国家规定体检标准的献血者 ,依照 CS-3 0…     

复方电解质注射液作添加液汇集血小板的研究

目的探讨复方电解质注射液作添加液（PAS）汇集多人份混合血小板的可行性。方法从400ml全血中分离白膜层（BC）,容量40～45ml,于22℃±2℃静置过夜,将ABO同型的6袋白膜汇集,加200ml复方电解质注射液稀释白膜,稀释后的白膜在温度22℃±2℃的离心机中,以900r／min离心10min。上层富含血小板悬液经白细胞过滤器去除白细胞,并转移到血小板保存袋内,即制备成1个成人治疗量的PAS汇集BC—PCs。结果共制备10个成人治疗量的PAS汇集BC—PCs,其容量、血小板含量、WBC混入量、RBC混入量分别为：（293±22）ml、（3．01±0．29）×10^11、（1．1±0．2）×10^6、（5．9±1．3）×10^3。保存8d后的pH、低渗休克反应率（HSR）、形变能力（ESC）、CD62P表达率、AnnexinV结合率分别为7．10±0．05、（65．6±7．1）％、（7．1±1．6）％、（27．4±3．3）％、（12．0±1．4）％。结论复方电解质注射液作为添加液汇集血小板的方法可行。     

浓缩血小板中病原体灭活技术研究进展

随着成分输血技术的不断进步 ,血小板的输注愈来愈引起临床医生的重视。然而 ,到目前为止 ,血小板的输注仍有一定风险 ,一是检测方法具有一定的局限性 ,还不能检出少数血液中感染的病毒和微生物 ;二是细菌学检查还未列入常规检测项目 ;三是血小板制品中 ,不能有效去除可能引发输血相关性移植物抗宿主病的Ｔ细胞。近年发展起来的血液成分病原体灭活技术 ,在提高输血安全性方面具有一定潜力。1　浓缩血小板输注中潜在的危险浓缩血小板输注具有潜在的传播病毒、细菌、微生物等引起的疾病的危险。通常认为 ,ＨＢＶ、ＨＣＶ、ＣＭＶ和逆转录病毒 …     

ADP诱导的血小板内钙离子浓度变化的研究

ADP被认为是动脉血栓形成的一个重要因素。在体外，ADP可诱发血小板内Ca2 浓度增高，为了探讨其机制及在临床诊断中的价值，我们应用流式细胞仪[1]和激光扫描共聚焦显微镜[2]观察负载ca2 荧光深外Fluo-3／AM的血小板在ADP作用下细胞内Ca2 变化。材料和方法1材料1．1试剂1．1．IADP（上海生物化学试剂厂产品），聚乙烯亚胺（日本TsurogaWomen’sJunior学院HiroakiNishio博士惠赠），A23187（美国Sigma公司），EGTA（美国Ser－va公司产品）。这些试剂均用不含Ca’”、Mg’”的PBS缓冲液配制。1．1．ZnU。－3／＊M（美国分子探…     

全麻原位肝移植患者术中酸碱及电解质浓度的变化

肝脏晚期病变导致的病理生理改变和手术创伤对机体的干扰 ,使机体围术期常出现严重的循环、电解质和酸碱紊乱。本文着重探讨原位肝移植术中不同时期患者血浆电解质及酸碱的变化及处理 ,以指导临床工作。1　对象和方法本组原位肝移植 2 3例 ,均系 2 0 0 1- 0 7～ 2 0 0 2 - 0 6在中山大学附属第一医院接受手术的晚期肝病患者。其中男 18例 ,女 5例 ,年龄 31～ 6 8岁 ,采用气管插管全身麻醉。诱导采用丙泊酚 2mg/ kg,芬太尼 3～ 5μg/ kg,维库溴胺 0 .1mg/ kg,维持为异氟醚或地氟醚吸入 ,芬太尼与维库溴胺间断静注。转流方法 :无肝期采用体外…     

Storage of platelet concentrates

The American National Red Cross has initiated a cooperative clinical study designed to evaluate the therapeutic effectiveness of fresh platelets and platelets stored at 4 or 22 C for up to 72 hours. Preliminary results, in confirmation of earlier work, indicate an inverse relationship between platelet count and bleeding time in patients with thrombocytopenia transfused with fresh platelets. Also, the observed rise in platelet count immediately following transfusion of fresh platelets is generally maintained for four to eight hours after which time it declines significantly.     

Chemokines in stored platelet concentrates

BACKGROUND: Platelets contain several mediators, belonging to a family of proinflammatory cytokines named chemokines, that are stored in the organelles. Release and accumulation of these chemokines during storage of platelet concentrates (PCs) might be responsible for nonhemolytic transfusion reactions. STUDY DESIGN AND METHODS: Analysis was done of pH and the levels of platelet factor 4, beta-thromboglobulin, interleukin 8, RANTES, macrophage-inflammatory protein-1 alpha, lactate dehydrogenase, and serotonin in the supernatant of stored PCs on Days 1, 3, 5, and 8. PCs were prepared by apheresis or from pools of four buffy coats. Buffy coat PCs were filtered before storage. RESULTS: Nonfiltered apheresis PCs, which had a higher white cell contamination (p < 0.01), contained significantly more platelets than did buffy coat PCs (p = 0.02). The pH decreased significantly in apheresis PCs (p = 0.01), whereas there was a significant increase in lactate dehydrogenase (p < 0.001). In buffy coat PCs, pH remained stable and lactate dehydrogenase increased moderately. Concentrations of platelet factor 4 and beta-thromboglobulin increased steadily in both preparations over the storage period (p < 0.001). Macrophage- inflammatory protein-1 alpha was hardly detectable in the supernatant of both PCs, while RANTES levels increased significantly with storage time (p < 0.001). Interleukin 8 was not found in the supernatant of any PCs, with the exception of one apheresis PC with high white cell contamination (> 10(9)/ L). Serotonin levels were higher in apheresis PCs (p = 0.01), but the levels did not correlate with storage time. CONCLUSION: Platelet factor 4, beta-thromboglobulin, and RANTES were released from platelets during storage and accumulated over time in the PCs. These chemokines might play a causative role in nonhemolytic transfusion reactions because of their inflammatory potential, but the clinical effects of the transfusion of PCs with high chemokine contents remain to be investigated.     

Bacterial proliferation in platelet concentrates

Growth curves of bacteria in platelet concentrates were studied to determine whether increasing the shelf-life of platelets from 3 to 7 days might have contributed to the increased number of deaths caused by contaminated platelets that have been reported to the FDA since 1980. Platelets inoculated with 10(3) organisms or more showed logarithmic bacterial growth throughout the 7 days of storage or until the platelets became visibly abnormal. With an inoculum of 10(2) organisms or less, proliferation patterns were variable: 20 percent (%) showed uninhibited logarithmic growth and 50 percent (%) remained sterile throughout the 7 days. In another 30 percent (%), bacterial growth was temporarily suppressed for 5 to 6 days before bacteria actively proliferated. These data support the hypothesis that bacterial contamination of platelets not clinically significant at 3 days of storage might become so during the current 7 day shelf life.     

Variation of pH-measurement in platelet concentrates

To measure pH in platelet concentrates, blood gas analysers with different calibration principles may be used. In this study, variances observed in pH measurements with two types of blood gas analysers were investigated. pH was measured in crystalloid solutions (platelet additive solution (PAS-II), phosphate-buffered solutions) and two types of platelet concentrates (containing 100% plasma, or 65% PAS-II/35% plasma) with two blood gas analysers: either using liquid and gas calibration (AVL 945), or only liquid calibration (AVL OMNI). These measurements were compared with a reference method. Especially for PAS-II, large variation in pH was observed between AVL 945, AVL OMNI and the reference method: 6.91 +/- 0.02, 7.35 +/- 0.02 and 7.188 +/- 0.010, respectively (mean +/- SD; n = 12, P < 0.0001, paired t-test). A significant difference in pH was also found for platelet concentrates in 65% PAS/35% plasma (6.88 +/- 0.09 on AVL 945 and 7.02 +/- 0.09 on AVL OMNI, n = 134, P < 0.0001). Comparison with the reference method revealed minor differences with AVL 945, whereas AVL OMNI gave a mean difference in pH of + 0.17. Platelets in 100% plasma revealed smaller differences (6.93 +/- 0.13 for AVL 945 and 6.99 +/- 0.13 for AVL OMNI, n = 95, P < 0.0001). We conclude that different blood gas analysers can yield different pH values, especially in weak buffered solutions such as platelet concentrates in PAS-II. Validation of blood gas analysers for pH measurement of these solutions is therefore mandatory.