两种设备分离冷沉淀质控抽检的质量比较

目的比较全自动冷沉淀制备仪与成分分离机制备的冷沉淀抽检合格率及质量。方法随机抽取2017年11月至2018年10月用成分分离机(简称分离机组)制备的冷沉淀48袋,与2018年11月至2019年10月全自动冷沉淀制备仪(简称自动组)制备的冷沉淀48袋,测定冷沉淀的VIII因子(FⅧ)和纤维蛋白原(Fib)含量,对照质量要求计算合格率,同时比较2组的质量,采用SPSS17.0做统计学分析。结果 FⅧ含量均值的比较,2种规格(2.0 U和1.5 U)自动组分别为(102.80±8.71)IU/袋和(77.19±8.77)IU/袋,分离机组分别为(84.77±3.92)IU/袋和(63.20±3.85)IU/袋(P均<0.05);Fib含量均值的比较,2种规格自动组分别为(214.53±16.04)mg/袋和(170.62±8.29)mg/袋,分离机组分别为(182.53±11.16)mg/袋和(129.50±9.36)mg/袋(P均<0.05);自动组和分离组抽检合格率比较,P<0.05。结论全自动冷沉淀制备仪制备的冷沉淀质量优于成分分离机,并且冷沉淀抽检合格率高于成分分离...     

Recombinant factor XIII A‐subunit in a patient with factor XIII deficiency and recurrent pregnancy loss

Essentials

• Inherited factor XIII deficiency is a very rare bleeding disorder.
• We used recombinant factor XIII‐A in a pregnant patient with factor XIII‐A subunit deficiency.
• The patient had a successful pregnancy outcome with no pregnancy related complications.
• The dose of recombinant factor XIII‐A was minimized by using frequent trough level monitoring.

Summary

Inherited factor XIII deficiency is a very rare bleeding disorder, and is one of the causes of recurrent pregnancy loss. The use of plasma‐derived FXIII to improve pregnancy outcomes has been reported. We report a 26‐year‐old woman with FXIII A‐subunit (FXIII‐A) deficiency who was treated with recombinant FXIII‐A and had a successful pregnancy outcome with no pregnancy‐related complications. Our case illustrates that the dose of recombinant FXIII‐A can be minimized and adjusted on the basis of frequent trough level monitoring.

     

去冷沉淀血浆与普通血浆临床应用价值的比较

目的探讨去冷沉淀血浆中部分有效成分的实际含量,为临床选择不同血浆输注提供实验室依据。方法采集23袋（200ml/袋）ACD-B血液保存液保存的血液,4h内分离制备新鲜冰冻血浆,各袋均留2份标本;1份同新鲜冰冻血浆一起置-35℃保存,于第3天速融后检测总蛋白、白蛋白、纤维蛋白原、凝血因子Ⅴ、Ⅷ、Ⅹ含量;1份置4℃保存21d后检测总蛋白、白蛋白、纤维蛋白原、凝血因子Ⅴ、Ⅷ、Ⅹ含量;新鲜冰冻血浆于第3天取出制备冷沉淀,留取去冷沉淀血浆标本1份检测总蛋白、白蛋白、纤维蛋白原、凝血因子Ⅴ、Ⅷ、Ⅹ含量。结果去冷沉淀血浆中的血浆蛋白和凝血因子均低于普通血浆（P〈0.001）。结论去冷沉淀血浆的使用价值有局限性,不能与普通血浆等同使用。     

2004-2010年度我院成分血应用分析

目的了解我院成分血应用现状,为输血科采血、备血及临床医生用血提供依据。方法对我院2004-2010年各成分血的应用情况进行统计分析。结果我院临床用血总量呈上升趋势;成分用血比例在99%以上,各种血液成分中,全血占0.21%,红细胞占52.90%,血浆占37.38%,血小板占5.16%,冷沉淀占4.35%;红细胞、血浆尤其冷沉淀主要用于外科,血小板主要用于内科;手术平均用血量红细胞和冷沉淀呈上升趋势,血小板与血浆缓慢下降。结论我院用血总量急剧增加,需要输血科积极招募献血员;我院成分血比例合理,但血小板应用比例太低,冷沉淀用量剧增,需要临床医生严格把握各成分血的输注指征。     

Bithermic Complement Activation in Cryoglobulinaemic Serum

Abstract. Cryoglobulin precipitates of the mixed type, containing 19 S IgM and 7 S IgG gamma globulin, were isolated from a patient serum and the interaction with serum C was studied. Loss of C activity in human serum incubated with cryoprecipitate was accompanied by the generation of C3 activity in the cryoglobulin aggregates. Complete dissociation of cryoprecipitation and the interaction of the precipitates with C was achieved at temperatures below 22°C and above 32°C respectively. The normal C titre in fresh serum of a cryoglobulinaemic patient was significantly reduced in vitro by first cooling and then rewarming the serum. The possible pathogenic role of the bithermic C activation in cryoglobulinaemic vascular lesions is discussed.     

Replacement therapy in platelet-type von Willebrand disease

The response to infusions of cryoprecipitate and factor VIII concentrate was studied in a patient with platelet-type von Willebrand disease (vWD) who showed lack of the large multimers of von Willebrand factor in plasma, increased platelet aggregation with low concentrations of ristocetin, and in vitro platelet aggregation by normal plasma. The cryoprecipitate and factor VIII concentrate to be infused induced platelet aggregation when added to patient platelet-rich plasma at concentrations higher than 0.86 U/ml and 3 U/ml of factor VIII-related antigen (VIIIR:Ag), respectively. Administration of cryoprecipitate (41.9 U VIIIR:Ag/kg body weight) was followed by a shortening of the bleeding time, and hemostasis was achieved during tooth extractions. Factor VIII concentrate (70.2 U VIIIR:Ag/kg) failed to correct the prolonged bleeding time and proved ineffective to control the gum bleeding. No significant diminution of the platelet count was observed following any infusion. These results indicate that cryoprecipitate is hemostatically effective and safe when infused in such a dosage, but factor VIII concentrate is not effective in platelet-type vWD in analogy to what is observed in various types of vWD.     

Novel cryoprecipitate for wound healing and skin grafts in rats

The authors sought to evaluate the ability of locally administered enhanced cryoprecipitate (eCryo) to improve the wound healing of split thickness skin grafts (STSG) and their donor sites. An STSG (5 × 5 cm) was harvested on the back of 30 rats and divided into four areas that were then treated in one of the following groups: A: ‘standard’ dressing without STSG; B: eCryo without STSG; C: eCryo with STSG coverage and D: STSG alone. Macroscopic and histological assessments (histomorphometric grading scale and cellular composition) were evaluated at days 7, 14, 21 and 28 for wound healing. All wound beds as well as STSGs healed well without any complications. Eighty per cent of the STSG showed a histological graft take of >75% after 28 days. There were no statistically significant differences of macroscopic or histological results between the groups at any time point. Preparation of eCryo is easy and effective. Its use as an adhesive for STSGs is safe and shows similar results as controls. The theoretical benefits of eCryo did not show significant differences. Possible reasons as well as important findings for future research on wound healing are discussed.