影响贮存血红细胞免疫功能的因素及检测方法改进的研究

目的： 简化规范红细胞免疫功能检测方法，提高其准确性、实用性；研究影响贮存血红细胞免疫功能的因素及质控指标。方法： 将以往国内外沿用的红细胞酵母菌花环试验涂片染色法改为直接镜检计数法，并对贮存血加保养液组与不加保养液组及贮存不同时间血液分别测定其红细胞免疫功能指标ＲＣＲ、ＲＩＣＲ、ＮＴＥＲＴ、ＤＴＥＲＴ和血液常规指标，进行统计学比较。结果： 直接镜检计数法测得ＲＣＲ和ＲＩＣＲ明显高于涂片染色法（ Ｐ＜０００１） ，前者的准确性、可重复性明显提高（ＣＶ１５５％ ） ；加保养液组ＲＣＲ 和ＲＩＣＲ 明显低于不加保养液组（ Ｐ＜００１） ；随着血液贮存时间的延长，ＲＩＣＲ 逐渐升高，ＲＣＲ、ＮＴＥＲＴ、ＤＴＥＲＴ则有不同程度降低，与采血当天测定值比较，分别于ｄ７ 、ｄ１４ 、ｄ２１ 、ｄ７ 、出现显著性差异，而血液常规指标除Ｈｂｄ２８ 出现显著性差异外，ＲＢＣ、ＨＣＴ均无统计学差异。结论： 直接镜检计数法是一种更为简便、快捷、准确、灵敏、实用的红细胞免疫功能检测技术；红细胞免疫功能应作为评价血液保存质量和指导临床输血的一项指标。

The study on the factors of influencing erythrocyte immune function of banking blood and the improvement of the detective technique

Objective: To research the improvement method for detecting erythrocyte immune function and study whether erythrocyte immune function was affected by nutrient and time change. Methods: The procedure of preparating smear and wright's staining in the yeast rosette test were omitted. The improved method of dropping directly the 37 ℃ hotted sample into the counting board and counting the rate of red cell rosette were adopted which was compared with the original method. The immune function of the erythrocyte that was preserred in various nutrient conditionand time range were measured by the improved method.Results: The rates of C 3b receptor rosette (RCR) and the rates of immune complex rosette (RICR) were obviously higher in the improved method than in the original method ( P <0 001); The RCR and RICR is clearly lower in the group with nutrient than in the group without nutrient ( P <0 01);As the time prolonged, RICR increased gradually, RCR and the rates of natural tumour erythrocyte rosette and the rates of direct tumour erythrocyte rosette declined gradually in different degree which were significantly different from the results detected immediately at d7, d14, d21, d7 respectively. Of the three routine blood parameters in each group, there are not significant difference except the result of Hb d28. Conclusion: Using the improved method,we can simplify the procedure, and decrease the influential factors, and raise the sensitivity and the accuracy of the test, which is favourable to developing clinic routing job. The immune function of erythrocyte should be regard as an index for evaluating erythrocyte quality.