Assessment of apheresis platelets during 5 days of storage: A National Cancer Institute,Cairo University experience

BackgroundPlatelet transfusion therapy is widely used to prevent hemorrhage in patients with thrombocytopenia and platelet disorders. The platelet concentrate (PC) quality is affected by increased storage time, as reflected in the decreased number of platelets, morphological changes, and impaired functions. This study aimed to analyze the impact of 5 days storage on platelets count and the expression of CD63, and Annexin V as activation markers during PC storage.MethodsFifty PCs collected from single donors were tested for platelet count on days 0, 3, and 5 using a Sysmex blood counter. CD61, CD63, and Annexin V expression was analyzed by a multicolor Navios flow cytometer.ResultsThere was a significant decrease in platelet count during 5 days of storage. There was a direct relationship between storage time and degree of platelet activation. CD63 had almost double increased expression on day 5 than day 3. Annexin V showed significantly increased expression on day 3 with minor differences between days 3 and 5.ConclusionAccording to standard blood bank conditions, PC stored for 5 days showed a degree of in vitro activation as evidenced by CD63 and Annexin V expression, may lead to reduced therapeutic efficacy. Flow cytometry monitoring platelet activation in PC offers a better understanding of the changes during PC storage and may help improve platelet products.     

全血于22℃保存24h分离制备悬浮红细胞及浓缩血小板的质量评价

目的 评价全血于22℃保存24 h分离制备悬浮红细胞及浓缩血小板的质量.方法 采用简单随机抽样法选择2014年5月至2015年2月广东省茂名市中心血站招募的60例献血者为研究对象.研究对象纳入标准:所有献血者献血前体检及相关血液学检查结果符合《献血者健康检查要求》(GB18467-2011)的相关规定.将60例献血者随机分为2组,每组各30例.两组献血者均分别采用五联采血袋采集全血各400mL,共计60袋全血.研究组献血者全血置于22℃保存和运输,并于采血后24 h制备悬浮红细胞和浓缩血小板.对照组献血者全血于22℃保存和运输,并于采血后8h内制备悬浮红细胞和浓缩血小板.两组献血者全血均采用白膜法制备悬浮红细胞和浓缩血小板.悬浮红细胞4℃保存至储存期末(制备后35 d),采用Bact/ALERT全自动微生物检测系统对其进行无菌试验;并比较两组悬浮红细胞的红细胞计数、血细胞比容(HCT)、血红蛋白(Hb)水平、游离血红蛋白(FHb)水平、储存期末溶血率,以及K+、Na+、C1-浓度.浓缩血小板22℃保存至储存期末(制备后5 d),采用Bact/ALERT全自动微生物检测系统对其进行无菌试验;并比较两组浓缩血小板的血小板含量、红细胞混入量、FHb水平、储存期末pH值、黏附率、聚集率及K+、Na+、C1浓度.结果 ①研究组与对照组悬浮红细胞储存35 d后,均无细菌生长;两组浓缩血小板储存5d后,均无细菌生长;②研究组与对照组悬浮红细胞储存35 d后,其血细胞比容(HCT)、血红蛋白(Hb)水平、储存期末溶血率均符合《全血及成分血质量要求》(GB18469-2012)的相关规定;两组悬浮红细胞的红细胞计数、HCT、Hb水平、FHb水平、储存期末溶血率及K+、Na+、Cl-浓度比较,差异均无统计学意义(t=0.55、0.51、1.18、0.48、0.72、2.86、2.07、2.40,P＞0.05);③两组浓缩血小板储存5d后,其血小板含量、红细胞混入量、储存期末pH值均符合《全血及成分血质量要求》(GB18469-2012)的相关规定;两组浓缩血小板的血小板含量、红细胞混入量、FHb水平、血小板黏附率、血小板聚集率,储存期末pH值,以及K+、Na+、Cl-浓度比较,差异均无统计学意义(t=0.17、0.16、0.56、2.43、0.36、2.50、1.85、1.75、0.32,P＞0.05).结论 22℃保存24 h制备的悬浮红细胞、浓缩血小板的质量符合国家标准,全血22℃保存过夜分离制备悬浮红细胞、浓缩血小板的方法可行.     

三七皂苷单体对高血压病人血小板功能的影响

目的:以硝苯地平及1{β[3-4-甲基苯丙氧基-甲氧苯]-1-H-盐酸咪唑}(SK&F96365)为对照,探讨三七皂苷单体人参皂苷-2A对血小板聚集功能的作用。方法:肘静脉采高血压病人血标本30份,正常人血标本30份,常规制备富含血小板血浆,分别用不同浓度的硝苯地平、SK&F96365、人参皂苷-2A孵育,以2μmol/L二磷腺苷为诱聚药,连续5次测定5分钟血小板的聚集率,以血小板最大聚集率(maximal platelet aggregation,PAGmax)为观察指标。结果:①高血压病人PAGmax为0.89±0.06,与正常人PAGmax0.68±0.07比较,差异有统计学意义(P<0.01);②两种浓度(10 μmol/L、20 μmol/L)的硝笨地平时正常人和高血压病人PAGmax均无影响;③4种浓度(2.5 μmol/L、5μmol/L、10μmol/L、20μmol/L)的SK&F96365对高血压病组的PAGmax均有抑制作用(均为P<0.05);④4种浓度(2.5μmol/L、5μmol/L、10μ,mol/L、20 μmol/L)的人参皂苷-2A对高血压病组的PAGmax均有抑制作用(均为P<0.05);3种浓度(5 μmol/L、10 μmol/L、20 μmol/L)的人参皂苷-2A对正常组的PAGmax均有抑制作用(均为P<0.05)。结论:高血压病人血小板聚集功能明显高于正常人,血小板呈高反应状态,是血栓形成的重要因素之一;硝苯地平不能抑制血小板聚集;SK&F96365能抑制血小板的聚集功能;人参皂     

血小板计数和持续全身炎症反应综合征预测急性胰腺炎并发多脏器功能不全的研究

目的　评估血小板计数和持续全身炎症反应综合征(SIRS)预测急性胰腺炎(AP)并发多脏器功能不全综合征(MODS)的价值。方法　回顾性分析152例AP病人的临床资料,按持续SIRS时间分为A组(无SIRS发生)、B组(持续SIRS≤3天)和C组(持续SIRS＞3天),比较各组血小板计数、MODS发生率和病死率,并描绘血小板计数预测AP并发MODS的ROC曲线。结果　入院24小时内3组病人的血小板计数有显著差异。SIRS＞3天组病人的MODS发生率及病死率明显高于其他2组。SIRS＞3天和血小板计数＜80×109/L预测AP并发MODS的似然比分别是12.65和5.29。血小板计数(80×10     

房颤患者血小板膜糖蛋白IIb／IIIa受体的变化及意义

目的：探讨心房纤颤患者血小板膜糖蛋白（GP）IIb/IIIa受体的变化及其临床意义。方法：采用全血法流式细胞术（FCM）对22例房颤患者静脉血中GPIIb/IIIa的含量进行检测,并与26例窦性心律者对照。结果：房颤患者血小板膜GPIIb/IIIa显著高于对照组（P＜0.01）;房颤患者中的持续房颤组高于阵发房颤组（P＜0.01）。结论：房颤引起血小板激活,激活程度可能与房颤持续时间有关。房颤患者处于血栓前状态。检测GPIIb／IIIa对评估房颤患者的栓塞危险性及指导抗凝、减少栓塞有重要意义。     

NLR、PLR在高血脂症性急性胰腺炎诊断及病情评估中的价值

目的探究中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)在高血脂症性急性胰腺炎(HLAP)诊断及病情评估中的价值。方法选取本院132例HLAP患者作为观察组,另选取同期66例胆源性、酒精性急性胰腺炎非HLAP患者作为对照组,66例健康体检者作为健康组,比较3组NLR、PLR、血脂指标[总胆固醇(TC)、三酰甘油(TG)]、炎性因子[C反应蛋白(CRP)、降钙素原(PCT)],分析NLR、PLR与血脂指标、炎性因子相关性,采用受试者工作特征(ROC)曲线评价NLR、PLR诊断价值,对比观察组不同病情程度患者NLR、PLR水平,分析NLR、PLR与HLAP病情程度的关系。结果观察组NLR、PLR、TC、TG、CRP、PCT高于对照组、健康组,对照组高于健康组,差异有统计学意义(P<0.05);Pearson相关性分析,NLR、PLR与TC、TG、CRP、PCT呈正相关(P<0.05);ROC曲线分析,NLR、PLR联合诊断AP的AUC为0.901,95%CI为0.858~0.934,敏感度为80.30%,特异度为92.42%,两者联合诊断HLAP的AUC为0.846,95%CI为0.788~0.893,敏感度为71.21%,特异度为83.33%,均优于两者单独诊断,差异有统计学意义(P<0.05);观察组重度患者NLR、PLR高于中度患者、轻度患者,中度患者高于轻度患者,差异有统计学意义(P<0.05);Spearman相关性分析,NLR、PLR与HLAP病情程度呈正相关(P<0.05)。结论 NLR、PLR联合检测在HLAP诊断与病情评估中具有较高临床价值。     

体外循环手术后血浆PAF、ⅠL-8、ⅠFN-γ的变化与急性肺损伤/急性呼吸窘迫综合征的相关性研究

目的：体外循环手术后测定血浆血小板激活因子（ PAF）、白细胞介素-8（ⅠL-8）、γ-干扰素（ⅠFN-γ）水平变化,分析血浆PAF、ⅠL-8、ⅠFN-γ水平与急性肺损伤/急性呼吸窘迫综合征关系。方法选择2006年12月份至2014年6月份应用体外循环手术治疗的156例患者作为观察对象,其中67例并发急性肺损伤/急性呼吸窘迫综合征,即观察组,另89例未发生急性肺损伤/急性呼吸窘迫综合征作为对照组。在术前、术后1d、3d及7d采用酶联免疫吸附测定法检测血浆中PAF、ⅠL-8及ⅠFN-γ浓度,并对结果进行统计学分析。结果观察组患者手术后血浆PAF、ⅠL-8和ⅠFN-γ浓度明显高于手术前（ P <0.05）;对照组患者手术前后各时段血浆PAF、ⅠL-8和ⅠFN-γ无明显波动（ P >0.05）;观察组血浆PAF、ⅠL-8和ⅠFN-γ浓度明显升高并在术后3 d时达最高值后逐渐下降,但术后各时间的浓度值均显著高于手术前（ P <0.05）;手术后同一时间点相比较,观察组血浆PAF、ⅠL-8和ⅠFN-γ水平显著高于对照组（ P <0.05）。结论体外循环手术后ALⅠ/ARDS患者血浆PAF、ⅠL-8和ⅠFN-γ变化显著,血浆PAF、ⅠL-8和ⅠFN-γ变化与ALⅠ/ARDS发生关系密切。     

New indicators in evaluation of hemolysis,elevated liver enzymes,and low platelet syndrome: A case-control study

BACKGROUNDIndices such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), mean platelet volume (MPV), platelet distribution width (PDW), and red cell distribution width (RDW) are considered new markers of the systemic inflammatory response (SIR), and have been widely implemented for the diagnosis of patients with inflammatory diseases. These new indicators have also been widely investigated in preeclampsia (PE) but less analyzed in hemolysis, elevated liver enzymes, and low platelet (HELLP) syndrome.AIMTo compare SIR markers among HELLP patients, PE only patients, and healthy gravidae.METHODSThis retrospective case-control study enrolled 630 cases, including 210 patients with HELLP syndrome (HELLP group), 210 patients with only PE (PE group) and 210 healthy gravidae (control group). The three groups were matched by age, parity, status of assisted reproduction, and multiple pregnancies. Birthweight, gestational age at complete blood count collection, gestational age at delivery, mode of delivery, etc. were recorded. The main indices as NLR, PLR, MPV, PDW, and RDW among the groups were compared, as well as some secondary outcomes including neutrophil, platelets, and hemoglobin.RESULTSThe NLR (6.4 vs 4.3 vs 3.5), MPV (11.9 vs 11.2 vs 10.7), PDW (16.4 vs 13.3 vs 14.2), leukocyte (12.4 × 10⁹/L vs 9.7 × 10⁹/L vs 8.7 × 10⁹/L) and neutrophil count (9.9 × 10⁹/L vs 7.3 × 10⁹/L vs 6.1 × 10⁹/L) were highest in the HELLP group, lower in the PE group, and lowest in the control group. Both the overall comparisons between the three groups (all ^bP < 0.01) and pairwise comparisons between every two groups elicited statistically significant differences (all ^dP < 0.01, except control vs PE: ^cP < 0.05 in PDW). The average lymphocyte counts were 1.4 (1.1, 2.0) × 10⁹/L in the HELLP group, 1.6 (1.3, 2.0) × 10⁹/L in the PE group and 1.7 (1.4, 2.0) × 10⁹/L in the control group. The overall comparison of lymphocyte count within the three groups had statistically significant differences (P = 0.000). The pairwise comparisons between every two groups demonstrated that the HELLP group had a lower lymphocyte count than both the PE (P = 0.019) and control groups (P = 0.000), but the difference between the PE and control groups was not statistically significant (P = 0.432). The overall comparisons on platelet counts and the PLR among these three groups also showed statistically significant differences (both P = 0.000), from low to high being those in the HELLP group (43.4 × 10⁹/L, 64.0), control group (180.5 × 10⁹/L, 103.6) and PE group (181.5 × 10⁹/L, 112.8). Pairwise comparisons of neither index displayed statistically significant differences between the PE and control groups (both P > 0.05), while the differences in the two indices between the HELLP group and the two other groups were still statistically significant (all P = 0.000). RDW values were highest in the HELLP group (14.5% [13.6, 15.3]), lower in the control group (14.1% [13.5, 14.8]) and lowest in the PE group (13.9% [13.4, 14.9]). The difference between the PE and control group did not show statistical significance (P = 1.000), while RDW values in the HELLP group were higher than those in the other two groups (^cP < 0.05 vs control, ^dP < 0.01 vs PE).CONCLUSIONSIR markers such as NLR, RDW, MPV, and PDW were increased and PLR was decreased in HELLP. These SIR markers may become new indicators in the evaluation of HELLP syndrome.