冷沉淀解冻后凝血因子变化的实验研究

目的探讨冰冻冷沉淀解冻融化后,在不同温度、不同时间凝血因子活性的变化,为临床使用冷沉淀提供理论依据。方法随机抽取12袋（200 mL/袋）新鲜冰冻血浆,用离心法制备冷沉淀12袋,每袋冷沉淀混匀后立即用保存管分装成多个样本（2 mL/管）,速冻后-30℃保存。样本在37℃融化后分成两组,一组置于4℃保存,另一组置于24℃保存,两组分别于0、3、6、12、24、36、48、60 h进行PT、APTT、TT、FIB、FⅡ、FⅤ、FⅦ、FⅧ、FⅨ、FⅪ水平测定。结果融化后的冷沉淀在不同温度保存,PT、APTT、TT、FIB、FⅤ、FⅨ、FⅪ变化差异无统计学意义（P〉0.05）,FⅡ、FⅦ和FⅧ变化差异有高度统计学意义（P〈0.01）。融化后的冷沉淀在两组温度保存48 h,APTT水平均有明显变化（P〈0.05）,在4℃6 h及24℃36 h,FⅧ水平下降均有高度统计学意义（P〈0.01）,且在4℃组保存,FⅧ衰减速度更快。除APTT、FⅧ外,其他指标在两种温度下60 h均无明显的改变。结论融化后的冷沉淀在60 h的保存期内,除FⅧ外,其他凝血因子活性没有明显的变化。在临床输注上,除非急需补充FⅧ,融化后保存60 h的冷沉淀仍可输注使用。

Experimental study of thawed cryoprecipitate clotting factor change

Objective To explore the changes of clotting factor activity of frozen cryoprecipitate after thawing in different temperature and time,which provided theory basis for clinical use of cryoprecipitate.Methods 12 samples of fresh frozen plasma were selected randomly,cryoprecipitate prepared by centrifugal method.Each bag of cryoprecipitate after mixing immediately to save tube distributed into multiple samples(2 mL/tube),frozen in-30℃.The sample was divided into two groups after melting at 37℃.One group was stored at 4℃ and the other was stored at 24℃.PT,APTT,TT,FIB,FⅡ,FⅤ,FⅦ,FⅧ,FⅨ and FⅪ were measured respectively at the time of 0,3,6,12,24,36,48 and 60 h.Results The changes of PT,APTT,TT,FIB,FⅤ,FⅨ and FⅪ were not significant different(P > 0.05),after thawing cryoprecipitate stored at different temperatures.But significant changes were observed in FⅡ,FⅦ and FⅧ(P < 0.01).Two groups APTT changes were observed over 48 h storage period at 4℃ and 24℃(P < 0.05).Both group activity of FⅧ were significantly reduced at 4℃ for 6 h and 24℃ for 36 h(P < 0.01).FⅧ reduced faster stored at 4℃ compared with 24℃ group.And other indicators changed no significant in both temperatures after 60 h.Conclusion Except for FⅧ,the other Coagulation factors activity do not change significantly for thawed cryoprecipitate after stored 60 h.In the clinical infusion,thawed cryoprecipitate in 60 h could be used to infuse exception of FⅧ.