洗涤血小板的质量检验和临床疗效观察

目的探讨洗涤血小板的制备方法、质量和临床应用效果。方法采用改良的全自动血细胞分离机制备洗涤血小板制剂。并应用生化方法、血细胞分析法和流式细胞技术对洗涤血小板中蛋白清除率、白细胞清除率、血小板回收率、血小板粘附聚集功能和CD62P、PAC-1的表达情况进行检测；观察输注洗涤血小板的临床疗效、过敏反应和非溶血性发热反应的发生情况。并与单采浓缩血小板比较。结果洗涤血小板的蛋白清除率为99％，白细胞清除率为85％，血小板回收率达95％；血小板洗涤前后的粘附率、聚集率、CD62P＋和PAC-1^＋表达率无统计学意义；临床输注后有效率达83％，与单采浓缩血小板输注有效率90％相比较无统计学意义。并且非溶血性发热反应和过敏反应的发生率分别下降了94．12％（16／17）和100％（13／13）。结论经该方法制备的洗涤血小板质量符合要求，血小板功能未受影响，临床输注后过敏反应和非溶血性发热反应明显下降，临床疗效肯定。

The Quality of Washed Platelet Concentrates and the Outcome of Transfusion

Objective To study the method of preparation,and to determine the quality of the washed platelet concentrates(PCs).To evaluate the outcome of transfusion using washed PCs.Method Washed PCs were prepared using a modified blood cell separator.The proteins removal rate,leukocytes removal rate,platelet recovery and properties(adhesion and aggregation),and the expression of CD62P and PAC-1 in washed PCs were determined using the biochemical methods,blood cell analysis methods,and monoclonal antibody.Febrile non-haemolytic transfusion reaction and allergic reaction were monitored after transfusing washed PCs.Result In the washed PCs,99% of the plasma and 85% of the leukocytes were removed.Platelet recovery was 95%.Significant difference in platelet adhesion,aggregation,and expression of CD62P and PAC-1 was not observed between the groups receiving apheresis PCs and washed PCs.After transfusion with washed PCs,the frequency of febrile non-haemolytic transfusion reaction(5.88%;1/17),and allergic reaction(0)was declined.Conclusion Washed PCs reached the quality of standard blood products.The washing procedures have no effect on the platelet function.The frequency of febrile non-haemolytic transfusion reaction or allergic reaction obviously declined after transfusion.The washed PCs are clinically satisfactory.