库存血浆胆碱酯酶水平测定及其临床意义

目的　观察库血保存天数与血浆胆碱酯酶 (cholinesterase,CHE)水平变化关系 ;探讨急性重症有机磷农药中毒 (acuteorganophosphoruspesticidepoisoning ,AOPP)抢救中合理选择用于换血疗法或者输入的血源。 方法　选取志愿供血者 1 0名 ,各抽取全血 2 0 0ml,完全按库血条件保存 ;逐日每份抽取血浆 2ml,快速测定血浆CHE值 ,重复2 1d ,血液中心当日抽血后即刻测定的血浆CHE值作为对照组。CHE测定用Roch公司的胆碱酯酶试剂盒 ,BeckManCx 9全自动分析仪测定。结果　库血保存天数为 1 1d以内与第 1 3天的血浆CHE值与对照组比较差异无显著性 (P >0 .0 5 ) ,1 2d以上的其他各组均显著低于对照组 (P <0 .0 5 ) ,且定基比均 <80 %。保存天数与血浆CHE值呈负相关 (r =- 0 .96 2 5 ,P <0 .0 1 )。曲线回归 y =0 .3835x3 - 1 0 .84 1x2 3.0 1 2 9x 41 6 1 .4 ,R2 =0 .96 1 7。结论　随采血后库血保存天数的增加 ,血浆CHE值逐渐下降。在重度AOPP抢救中 ,以使用保留天数为 1 1d以内新鲜血浆为宜 ,尤以保存天数最短者为优。本报告为强调输入新鲜血浆 ,提供实验依据。

The Determination of Plasma Cholinesterase Level in Banked Blood and its Clinical Significance

Objective To study the relationship between the preservation days of banked blood and the altered plasma cholinesterase level with the aim of making proper selection of banked blood in the emergency treatment of acute organophosphorus pesticide poisoning (AOPP).Methods Ten healthy volunteers were included in this study from whom two hundred milliliters of whole blood was collected and stored exactly as the standard banked blood.Two milliliters between the plasma were collected from each blood sample for quick assay between the plasma cholinesterase.This procedure had been repeated for 21 days.The plasma cholinesterase value was determined on blood samples in Blood Center on the same day which served as a control.The cholinesterase value was determined with a kit of Roch Company and Beck Man Cx 9 automatic biochemical analyzer.Results It was found that there was no significant difference of plasma cholinesterase value in banked blood stored within eleven days and the control group or between the thirteenth day and the control group ( P >0.05),but the plasma cholinesterase values of the other experiment groups were all significantly lower than that of the control group ( P <0.05).And as compared with the control group,the relative ratio with fixed base was lower 80 percent after twelve days.It seemed that the preservation days were in negative correlation with the plasma cholinesterase value (r=-0.9625,P <0.01).The curvilinear regression equation was y =0.3835x 3-10.841x 2 3.0129 x 4161.4, R 2=0.9617.Conclusion With the increase of the banked blood preservation days,the plasma cholinesterase value decreased gradually.So in the emergency treatment of severe AOPP,it is advised to use the fresh plasma preserved within eleven days,the shorter the time preserved the better.This study provides the experimental basis for emphasizing transfusion of fresh plasma.