仪器法和手工法检测单采血小板RBC和WBC混入量的比较研究

目的:通过比较仪器法和手工法计数单采血小板中混入的红细胞和残留的白细胞,评价2种方法在单采血小板的质量评价过程中的适用性。方法:收集MCS+机型、Amicus机型和Trima机型3种仪器设备采集的保存期内的单采血小板各30例,记录献血员的基本资料,用全自动血细胞计数仪法和手工法计数单采血小板中混入的红细胞和白细胞,然后进行统计学分析。结果:献血前3组机型的献血员HCT、外周血WBC、RBC均差异无统计学意义。3组机型采集的单采血小板产品每袋血小板含量差异无统计学意义(P0.05)。3组机型的红细胞混入量仪器法计数均高于手工法(配对t检验,P0.05),手工法计数可显著提高红细胞混入量的合格率(χ2检验,P0.05)。MCS+机型的单采血小板中白细胞混入量手工法和仪器法计数差异无统计学意义(P0.05),Amicus和Trima 2种机型的单采血小板产品手工法计数白细胞均低于仪器法(P0.05),但手工计数法只能提高Amicus机型的白细胞混入量合格率,对另外2种机型的单采血小板白细胞混入量合格率无影响。结论:在对单采血小板进行质量评价时,对于红细胞混入量的计数,手工计数比全自动血细胞计数仪更适用;但对于白细胞混入量的计数,MCS+机型和Trima机型2种方法均可,而Amicus机型手工法比全自动血细胞计数仪更适用。     

45岁以上固定大量献血者铁蛋白及血红蛋白水平调查

目的:了解青岛地区45岁以上固定大量无偿献血者铁蛋白(FER)、血红蛋白(HGB)等检测情况,评估固定大量无偿献血对献血者铁代谢及血红蛋白等健康指标的影响,为无偿献血招募宣传策略提供科学依据。方法:招募2006—2016年青岛地区45~65岁固定大量无偿献血者,采集空腹静脉血,检测指标:FER、HGB、红细胞计数(RBC)、血细胞比容(HCT)、平均红细胞体积(MCV)。从某三级甲等医院查体中心随机抽取45~65岁未献过血志愿者作为对照,按不同年龄段及性别分组,进行统计学分析。结果:(1)45~54岁男性大量献血者的FER显著低于未献血组(P0.01),HCT低于未献血组(P0.05),RBC、HGB、MCV与对照组比较差异无统计学意义(P0.05)。(2)55~65岁男性大量献血者FER低于同年龄未献血组(P0.05),HGB、RBC、HCT、MCV与对照组比较差异无统计学意义(P0.05)。(3)45~50岁女性献血者的FER、RBC、HGB、HCT、MCV与对照组比较均差异无统计学意义(P0.05)。(4)51~65岁女性献血者的FER低于未献血组(P0.05),HGB、MCV高于未献血组(P0.05),RBC、HCT与未献血组比较差异无统计学意义(P0.05)。(5)男性大量献血者FER与献血量之间呈显著负相关(P0.01);HGB与献血量之间呈负相关,P0.05,HCT与献血量之间呈显著负相关,(P0.01),而RBC及MCV与献血量之间无相关性(P0.05);女性大量献血者FER、RBC、HGB、HCT、MCV与献血量之间无相关性(P0.05)。(6)男性大量献血者,FER高于正常范围的例数与不献血组比较有统计学差异(P0.01)。而女性大量献血者,FER高于正常范围的例数与不献血组比较差异无统计学意义(P0.05)。结论:45岁以上男性长期大量献血FER低于不献血人群,但未引起HGB、RBC、MCV的降低,FER的降低与献血量相关;FER高于正常比例少于不献血组。45~50岁女性大量献血者未见FER、RBC、HGB、HCT、MCV的降低,而51~65岁女性献血者的FER低于未献血组。针对不同性别、年龄的大量献血者应采取不同的招募措施和延伸服务。     

献血者定期一次性单采2U血小板的安全性分析

目的:探讨固定献血者定期一次性单采2U血小板的安全性。方法:按照《献血者健康检查要求》(GB18467-2011),研究52例单采献血者按每2周间隔时间且每次均采集血小板2U,分别于采后30min和14d留取献血者静脉血样进行血常规各项指标检测,同时考察单采6个月后免疫功能指标。结果:单采献血者采后30min除血小板相关指标(PLT、MPV、PDW、P-LCR)与采前比较差异有统计学意义(均P0.05),其他各项指标(WBC、RBC、Hb、Hct、MCV)则差异无统计学意义(均P0.05);采后14d留样观察与采前比较差异无统计学意义(均P0.05);连续单采6个月献血者的免疫性指标(IgG、IgM、IgA)及T淋巴细胞亚群的水平与捐献全血的献血者(n=60)之间差异无统计学意义(均P0.05)。结论:定期每2周一次性单采2U血小板能保证献血者的安全,且产品质量符合国家标准,能很好地缓解临床供需矛盾。     

多次单采血小板对献血者健康状况的影响

目的观察探讨多次单采血小板对献血者健康状况的影响,总结其临床意义。方法选取我站2008年8月—2012年5月32例自愿献血者,均进行多次单采血小板,观察比较单采前和单采10次后血小板、血细胞及血浆总蛋白的变化。结果单采10次后的血小板计数(PLT)、大形血小板(P-LCR)、血小板分布宽度(PDW)与单采前比较,差异有统计学意义(P<0.05);单采10次后的红细胞计数(RBC)、白细胞计数(WBC)、红细胞压积(HCT)、血浆总蛋白与单采前比较,差异无统计学意义(P>0.05)。结论多次单采血小板对献血者健康状况无明显影响,虽然采集血小板后血浆蛋白会有一定下降,但仍在参考范围内,长期献血小板的献血者,能够促造血系统起协同作用,恢复循环中的血小板数目,具有重要的临床意义。     

缩短机采血小板献血间隔期前后献血者的血常规变化分析

目的:分析机采血小板固定献血者缩短献血间隔期前后血常规的变化,了解对献血者健康的影响。方法:随机抽取40名机采血小板固定献血者为研究组,监测献血间隔期从≥4周缩短到≥2周前后的血常规,以及同期首次机采血小板献血者对照组40名血常规进行分析。结果:研究组缩短献血间隔期前后血常规变化差异均无统计学意义(均P0.05),研究组缩短献血间隔期前后血常规与同期首次机采血小板献血者的血常规比较,WBC、RBC和Hb的差异均无统计学意义(均P0.05),MPV、HCT和PLT差异有统计学意义(P0.05)。结论:缩短献血间隔期前后,机采血小板固定献血者自身血常规变化差异无统计学意义(P0.05),与同期首次机采血小板献血者的血常规比较,WBC、RBC和Hb差异无统计学意义(P0.05),MPV、HCT和PLT下降,但均在正常范围。缩短献血间隔期对献血者健康无明显影响。     

多次单采成分献血者铁蛋白代谢及贫血相关指标水平变化研究

目的:了解多次单采成分血献血者铁蛋白代谢及贫血相关指标变化情况。方法:按照是否多次捐献单采成分血进行分组,试验组：多次单采成分血献血者150例;对照组：以往无献血史,首次来血站进行献血者150例。为了解各相关指标与年龄的相关性,将每组再按性别分成18～35岁,36～45岁,46～60岁3个年龄段。利用全自动血球分析仪对抗凝标本进行红细胞(RBC)、血红蛋白(Hb)、血细胞比容(HCT)、平均红细胞体积(MCV)、红细胞分布宽度(RDW)等血细胞指标检测;利用全自动生化分析仪对促凝标本进行铁蛋白(FER)、叶酸和维生素B12(VitB12)等项目检测。结果:试验组男性RBC、Hb、叶酸较对照组升高,FER、VitB12水平降低,差异均有统计学意义(P<0.05);试验组女性FER较对照组降低(P<0.05),36～45岁水平最低,在46～60岁时有明显回升。男性VitB12水平总体有所降低,女性总体有所升高,在46～60岁男性与女性均较其他年龄段明显降低,差异有统计学意义(P<0.05)。多次单采成分组FER、叶酸和VitB12水平于献血当天水平最低,后期逐渐回升,28...     

国产某型~(137)Cs γ射线辐照仪辐照血液制品的应用研究

目的:研究某型国产~(137)CSγ射线血液辐照机辐照后血液制品质量以及血液制品中淋巴细胞增殖能力的变化,评估患者输注后的临床疗效。方法:选取悬浮红细胞和单采血小板为试验对象,分为对照组和辐照组,使用某型国产~(137)Csγ射线血液辐照仪进行辐照,试验用辐照剂量为25 Gy。对悬浮红细胞组进行红细胞计数(RBC)、血细胞比容(Hct)、红细胞平均体积(MCV)、血浆游离血红蛋白(FHb)检测,分离红细胞中的淋巴细胞进行增殖培养。血小板组进行血小板计数(PLT)、血小板平均体积(MPV)检测。计算悬浮红细胞和血小板的破坏率、回收率,计算淋巴细胞增殖能力的下降指数;同时对接受血液制品输注的患者进行血常规、肝功能和肾功能检测,评估输血前后生理功能的变化和输血疗效。结果:红细胞组辐照后与辐照前比较,RBC、Hct、MCV、FHb差异无统计学意义(P0.05);淋巴细胞增殖率下降,差异有统计学意义(P0.05)。血小板组辐照后与辐照前比较,PLT、MPV差异无统计学意义(P0.05);红细胞和血小板的破坏率、回收率符合要求。患者接受血液制品输注后肝功能、肾功能实验室检测数据变化差异无统计学意义(P0.05),无输血不良事件发生,输血疗效变化差异有统计学意义(P0.05)。结论:该型辐照机辐照后血液制品质量和功能未受影响,淋巴细胞增殖率下降,受血者接受辐照后血液制品输注疗效明显,无输血不良反应。     

高脂血浆对血红蛋白测定的影响及其校正

目的：研究高血脂因素干扰血红蛋白（Hb）比色测定的校正实验方法。方法：56例高血脂标本直接进行全血细胞分析后再低速离心,吸弃上层浑浊血浆,分别用等量生理盐水和仪器配套稀释液替代血浆后再进行Hb测定;同时根据文献报道的Hb估算公式计算Hb数值。结果：高脂血症组直接测定的Hb值、平均红细胞血红蛋白含量（MCH）值、平均红细胞血红蛋白浓度（MCHC）值均明显高于生理盐水组、稀释液组、估算组的测定值,差异有统计学意义（P〈0．01）;生理盐水组与稀释液组间测定的Hb、MCH、MCHC值比较,差异无统计学意义;高脂血症组直接测定的MCV值与生理盐水组、稀释液组、估算组测定的MCV值间差异无统计学意义。结论：低速离心吸弃上层浑浊高脂血浆对红细胞形态无明显改变;等量生理盐水或仪器配套稀释液替代浑浊高脂血浆,可避免高脂血因素对Hb测定的影响,能对Hb比色测定结果进行校正。     

育龄妇女血清铁蛋白、平均红细胞体积和平均红细胞血红蛋白量测定分析

为了探讨血清铁蛋白(SF)、平均红细胞体积(MCV)和平均红细胞血红蛋白量(MCH)检测在育龄妇女缺铁性贫血(IDA)诊断中的价值，对1314例育龄妇女(其中孕妇869例，非孕妇445例)外周血SF、MCV、MCH进行检测，其中对Hb＜110g/L的157例孕妇、Hb＜120g/L的111例非妊娠妇女及1046例非IDA对照组进行比较，并对869例孕妇按孕周分为妊娠早期组248例，中期组345例和晚期组276例进行比较。结果显示：①与对照组比较，IDA孕妇组和IDA非孕妇组的SF、MCH、MCV均显著下降(P＜0．01)。②妊娠早期组、中期组及晚期组比较，SF随孕周增加而减少，均有显著性差异(P＜0.01)；MCV、MCH未有显著性差异。认为SF、MCV、MCH降低是IDA的特征性改变，其检测有助于IDA的鉴别诊断，定期监测妇女血清SF对早期发现铁缺乏有重要意义。     

网织红细胞血红蛋白含量结合铁代谢参数在诊断成人缺铁性贫血中的临床价值

目的 探讨网织红细胞血红蛋白含量(Ret-He)结合铁代谢参数诊断成人缺铁性贫血(IDA)的临床价值。方法 选取该院血液科2018-11～2019-10收治的165例患者,检测各自红细胞参数[血红蛋白(Hb)、红细胞平均体积(MCV)、红细胞平均血红蛋白含量(MCH)]、网织红细胞参数(Ret-He)、铁代谢参数[血清铁(SI)、血清铁蛋白(SF)]及炎症标志物[C反应蛋白(CRP)]。根据Hb水平和骨髓铁染色结果将受试者分为缺铁性贫血组(IDA组) 53例、非缺铁性贫血组(NIDA组) 34例、缺铁非贫血组35例和对照组43例,比较各组间上述指标的差异,并考虑炎症的影响。绘制各血液分析指标单独诊断IDA和Ret-He+SI+SF结合诊断IDA的受试者工作特征(ROC)曲线,计算各自的灵敏度和特异度。结果 IDA组各参数水平明显低于NIDA组、缺铁非贫血组和对照组,差异均有统计学意义(P 0. 05); NIDA组SI、SF水平明显高于缺铁非贫血组和对照组,差异均有统计学意义(P 0. 05);缺铁非贫血组Ret-He、Hb、MCV、MCH、SI、SF水平明显低于对照组,差异均有统计学意义(P 0. 05)。炎症组与无炎症组患者血液SI、SF水平差异有统计学意义(P 0. 05),Ret-He、Hb、MCV、MCH水平差异无统计学意义(P 0. 05)。ROC曲线分析结果表明,Ret-He诊断IDA的cut-off值为28. 8 pg,灵敏度为91. 1%,特异度为90. 9%,曲线下面积(AUC)为0. 947(95%CI:0. 875～0. 984)。Ret-He+SI+SF结合诊断IDA的灵敏度为92. 7%,特异度为93. 5%,AUC为0. 959(95%CI:0. 900～0. 988)。结论 Ret-He结合SI、SF诊断IDA具有较高的临床价值,其综合诊断效能优于Ret-He、Hb、MCV、MCH、SI、SF等指标的单独诊断。     

联合输注单采血小板和冷沉淀凝血因子在急性大失血患者中的治疗作用

目的：研究急诊联合输注单采血小板和冷沉淀在治疗急性大失血患者患者中的疗效。方法：急性大失血患者随机分为3组：单采血小板与冷沉淀凝血因子联合输注组（共43例）,单采血小板单独输注组（共13例）和冷沉淀凝血因子单独输注组（共11例）。联合输注组先后输注血小板10U,冷沉淀凝血因子10U;单采血小板单独输注组,给予单采血小板10U;冷沉淀凝血因子单独输注组给予冷沉淀凝血因子10U输注。检测治疗前后血浆凝血酶原时间（PT）、血浆部分凝血活酶时间（APTT）、凝血酶时间（TT）、纤维蛋白原（Fbg）、血小板计数（PLT）。结果：与输注单采血小板组和冷沉淀组相比,联合输注组PT、APTT、TT均显著性缩短（P〈0.05或P〈0.01）,有效止血率明显增高（P〈0.01）,平均止血时间明显缩短（P〈0.01）,24h内悬浮红细胞续用量显著减少（P〈0.01）。结论：在大量失血患者的治疗中,联合输注血小板及冷沉淀能显著改善凝血功能,促进止血功能,具有更显著的止血效果。     

Use of capillary blood count parameters in adults

BACKGROUND AND OBJECTIVES: Capillary samples can provide blood for cell counts in haematologic patients and blood donors. However, some accept only values from venous blood. This study compares capillary and venous blood counts to verify the hypothesis that they are equivalent. MATERIALS AND METHODS: We analysed 463 capillary (fingerstick) and venous blood samples from 428 adults of both sexes (71% haematologic patients, 29% potential blood and apheresis donors). Both samples were taken at the same time from each subject. Haemoglobin (Hb), haematocrit (Hct), white blood cells (WBC), platelets, red blood cells (RBC), mean corpuscular volume (MCV), mean corpuscular Hb (MCH) and mean corpuscular Hb concentration (MCHC) were measured using a haematology analyser (Advia 120, Bayer). RESULTS: Capillary Hb, Hct, WBC, RBC, MCV and MCH were all significantly higher than the venous values [+0.2 mmol/l (+0.3 g/dl), +0.02 l/l (+2%), +0.2 x 10(9)/l, +0.1 x 10(12)/l, +3.1 fl and +0.01 fmol, respectively], whereas the capillary MCHC was lower (-0.6 mmol/l). There was no difference in platelets (-1 x 10(9)/l). Capillary Hb and Hct values were higher in patients with anaemia and polycythaemia, respectively. However, no significant differences occurred in severe thrombocytopenia. CONCLUSION: In adult haematologic patients, however, only the differences in Hb and Hct values may be of clinical relevance. For potential blood and apheresis donors, Hb and platelet screening are equivalent with either capillary and venous blood using a haematology analyser.     

Red cell indices as predictors of iron depletion in blood donors

The objective of this study was to investigate whether red cell indices mean cell volume (MCV) and mean cell haemoglobin (MCH) were lower in frequent blood donors and hence, indirectly, able to predict impending iron depletion. Serum ferritin and/or soluble transferrin receptor levels can be used to evaluate iron status but are not practical for routinely screening blood donors prior to donation. Hb, MCV and MCH were measured on venous blood from 886 blood donors using a Sysmex E-5000. Full details were obtained for all donors of each earlier donation over the previous 3 years. MCV and MCH levels were lowest in donors with the highest frequency of previous blood donation. There was a significant negative correlation between MCV and number of donations in males and females and between MCH and number of donations in females, over the 3 year period 1995-97. Similar trends were observed when only the previous year's donations (1997) were considered with all categories showing significant negative correlations and additionally, Hb levels in females showed negative correlation with number of donations in 1997. In conclusion, increased frequency of blood donations is associated with lower MCV and MCH. These red cell indices, or more sophisticated parameters such as percentage hypochromic cells, should be used to monitor early onset of iron depletion in frequent blood donors.     

Red blood cell indices as an effective marker for the existence and severity of endometriosis (STROBE)

To evaluate the association between red blood cell (RBC) indices (mean corpuscular volume [MCV], mean corpuscular hemoglobin [MCH], MCH concentration [MCHC], red cell distribution width [RDW], hemoglobin [Hb], hematocrit [Hct], and neutrophil-to-lymphocyte ratio [NLR]) and the severity of endometriosis.Data were obtained from the medical records of 200 patients with endometriosis (stage I/II and stage III/IV groups), and 100 patients with benign ovarian tumors (control group), treated between September 2011 and April 2021.The mean Hb and Hct were significantly lower in the stage III/IV group compared to those in the control and stage I/II group (P = .015 and P = .004, respectively). The mean MCV, MCH, and Hb at postoperative day (POD)#1 were significantly lower in the stage III/IV group compared to those in the control and stage I/II group (P = .007, P = .032, and P < .0001, respectively). In addition, NLR at POD#1 was significantly higher in stage III/IV group compared to that in the control and stage I/II group. Multivariate analysis revealed that younger age (≤38 years old), lower preoperative MCV (≤88.5 fL), lower POD#1 Hb (<11.6g/dL), and higher POD#1 NLR (>2.5) were independent risk factors of stage III/IV endometriosis.Lower levels of RBC indices, including preoperative MCV and postoperative Hb, and higher postoperative NLR were significantly associated with the severity of endometriosis, which is potentially derived from a dysregulation in iron metabolism and inflammation.     

2000例无贫血体检成人静脉血的红细胞平均体积结果分析

目的：通过对无贫血体检成人静脉血红细胞平均体积（MCV）结果的分析，了解无贫血人群的MCV分布情况，明确MCV在无贫血人群中测定的意义，同时为正确制定MCV参考区间提供依据。方法：收集一般体检结果正常的成人静脉血2000例，其中男和女各分18～45岁、46岁以上2组，每组各500例，测定MCV，画出各组结果的分布直方图，统计各组结果的均值和标准差，剔除异常分布结果后在统计均值和标准差，并对各组结果进行比较分析。结果：无贫血人群呈双峰分布，其中一峰为小细胞峰，峰值约在65～70fl处；剔除小细胞群后所得均值和95％可信区间与全国平均水平接近；46岁以上男性MCV比其他各组明显偏高。结论：无贫血人群中存在一定比例的小细胞人群，在制定参考区间时应将其剔除，但用一般剔除方法不能将其剔除，可直接剔除MCV小于75fl结果后进行统计；46岁以上男性MCV明显比女性、45岁以下男性的MCV高，在制定MCV参考区间时不应纳人参考人群。     

红细胞保存液混悬洗涤红细胞的质量观察

目的:检测红细胞保存液(MAP)混悬洗涤红细胞在保存有效期内的质量指标。方法:随机将悬浮红细胞分为2组,1组不洗涤(对照组),1组用生理盐水洗涤最后用MAP混悬(实验组),4℃±2℃冰箱保存,分别在保存期7、14、21、28、35d同时取样,按洗涤红细胞质量标准进行检测。结果:实验组和对照组在保存期末(35d)的血红蛋白含量、上清液蛋白含量、溶血率及无菌试验均符合国家标准;但实验组洗涤红细胞在保存21d后溶血率明显升高至保存末期35d,溶血率为(0.110±0.035),与7d时比较,差异有统计学意义(P0.01)。结论:使用MAP混悬洗涤红细胞至保存期末质量符合标准,但溶血率随时间延长而逐渐升高,建议最好在保存期21d内的洗涤红细胞应用临床为佳。     

冷凝集对血细胞分析多项参数检测结果的影响

目的 探讨红细胞冷凝集对血细胞分析各项检测参数的影响及处理方法.方法 选择福建省肿瘤医院2017年12月至2020年2月有红细胞冷凝集的全血标本73份.应用Sysmex XN-9000全自动血细胞分析仪对标本进行检测,比较37℃水浴前后红细胞(RBC)、血细胞比容(HCT)、平均红细胞体积(MCV)、平均红细胞血红蛋白...     

Correlations between changes in hematological indices of mothers with preeclampsia and umbilical cord blood of newborns

Preeclampsia is a condition that might severely impact the health of mothers and their newborns. The aim of this investigation is to examine hematological parameters in mothers with preeclampsia and umbilical cord blood. Eighty preecalmptic mothers were recruited in the study. In addition, eighty normal pregnant mothers served as controls. Hematological parameters that include hemoglobin (Hb), red blood cell count (RBC), red cell distribution width (RDW), packed cell volume (PCV), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), white blood cell counts (WBC), platelet counts, mean platelet volume (MPV) and Platelet large cell ratio (PLCR) were examined. Results showed a strong association between preeclampsia and low birth weight, premature/cesarean delivery and proteinuria (P < 0.001). Hb and neutrophils were significantly lower (P < 0.01), whereas RDW, PCV, MCV, MCH, MCHC and lymphocytes were significantly higher than normal ones (P < 0.01). When cord blood of preeclamptic mothers were compared with that of normal ones, similar findings were observed. In addition, results showed significant and positive correlations between preeclamptic mothers and their newborn in Hb (r2 = 0.075, P < 0.05), PCV (r2 = 0.084, P < 0.01), MCV (r2 = 0.077, P < 0.05), MCHC (r2 = 0.115, P < 0.01), RBC (r2 = 0.086, P < 0.01) and retics (r2 = 0.306, P < 0.01). In conclusion, changes in several hematological parameters associated with preeclampsia were correlated in affected mothers and their newborns. Such biomarkers can be used to predict pregnancy outcomes in women with preeclampsia.     

The Hb E (HBB: c.79G>A), Mean Corpuscular Volume,Mean Corpuscular Hemoglobin Cutoff Points in Double Heterozygous Hb E/– –SEA α-Thalassemia-1 Carriers are Dependent on Hemoglobin Levels

Identifying double heterozygosities in Hb E (HBB: c.79?G>A)/– –^SEA (Southeast Asian) (α-thalassemia-1) (α-thal-1) in patients first diagnosed as carrying Hb E is important in thalassemia control. Low Hb E, mean corpuscular volume (MCV) and mean corpuscular hemoglobin (Hb) (MCH) levels have been observed in this double heterozygosity. However, the cutoff points of these parameters have never been systematically established. Here, we analyzed Hb E and red blood cell (RBC) parameters in 372 Hb E patients grouped by Hb levels, by the status of – –^SEA and –α^3.7 (α-thal-2; rightward) deletions, to establish the cutoff points. Then, the established cutoff points were evaluated in 184 Hb E patients. It was found that the cutoff points of Hb E, MCV, MCH were significantly dependent on the Hb levels. In the group having Hb levels <10.0?g/dL, the cutoff points of Hb E, MCV and MCH were 21.2%, 64.9?fL and 21.0?pg, respectively, and were 25.6%, 72.8?fL and 23.9?pg, respectively, in the group having Hb levels 10.0–11.9?g/dL. Finally, in the group having Hb levels ≥12.0?g/dL, the cutoff points of Hb E, MCV and MCH were 27.1%, 76.7?fL and 25.3?pg, respectively. Thus, to screen for the double heterozygous Hb E/– –^SEA anomaly in patients initially diagnosed as carrying Hb E, the Hb levels must be taken into account in choosing the suitable cutoff points of these three parameters.     

120例回收式自体输血在非停跳冠状动脉旁路移植术中的临床应用分析

目的：观察回收式自体输血在非停跳冠状动脉旁路移植术（OPCABG）中应用的临床效果。方法：我院择期行OPCABG ASAⅡ～Ⅲ,心功能Ⅱ～Ⅲ（NYHA）,且自愿接受自体血回输患者120例。监测患者术前及术中HR、平均动脉压（MAP）、氧分压（PaO2）、血细胞比容（Hct）、血小板计数（PLT）、活化凝血时间（ACT）及凝血酶原时间（PT）等的变化。同时分别于术前和回输后采外周静脉血2 mL,自体血回输前,即刻采集同体积洗涤红细胞涂片,显微镜下观察红细胞形态,且留取回输前即刻至回输后3h内的尿样行尿血红蛋白定性检测。结果：自体血回输前MAP较术前下降,HR略有升高,回输后二者已基本恢复到术前水平;而Hb,Hct和PLT均较术前明显降低,PT延长;而自体血回输后,HB、HCT显著回升,机体低血红蛋白状态得到改善;自体血回输后,PLT和PT在正常范围内,较回输前无明显变化;ACT值略有下降,但同术前相比,差异无统计学意义（P〉0.05）。洗涤红细胞涂片可见红细胞棘状变形,约4～6个/高倍视野,占总数的15%～25%,偶见红细胞碎片,而自体血回输后涂片,红细胞形态大致正常,少见变形红细胞,未见红细胞碎片。尿血红蛋白定性检测结果：血红蛋白尿弱阳性3例,血红蛋白尿比例为2.5%。结论：回收式自体输血可节约血源,纠正失血及贫血,维持血流动力学稳定,对凝血功能无明显影响,在非体外循环冠状动脉旁路移植术中,回收式自体输血作为一种血液保护措施,可应用于临床。