改良白膜法制备浓缩血小板及回收率的影响因素

摘要

背景：白膜法和富含血浆法制备的浓缩血小板有无效输注发生率高和不良反应发生率高的缺点。　　目的：观察改良白膜法制备浓缩血小板的实验研究，分析制备浓缩血小板回收率的影响因素。　　方法：随机抽取126例站内采集后4-6 h的400 mL血液，随机分成改良白膜法组、白膜法组和富含血浆法组。改良白膜法采用3步离心，第1次采用次重离心，离心转速2300 r/min，离心时间12 min，降速5，离心温度(22±2)℃；第2次采用轻离心，离心转速910 r/min，离心时间10 min，离心温度(22±2)℃；第3次离心转速2800 r/min，离心时间12 min，离心温度(22±2)℃，离心后，挤去上层含血小板较少的血浆，袋中留30 mL血浆悬浮血小板，即为浓缩血小板。通过数据库文献检索的方法分析制备浓缩血小板回收率的影响因素。　　结果与结论：改良白膜法、白膜法以及富含血浆法制备的手工浓缩血小板中，制备前各组血小板总数差别无统计学意义(P >0.05)；富含血浆法组和改良白膜法组较白膜法组血小板回收率高，差异有显著性意义(P <0.05)，但富含血浆法组和改良白膜法组比较，差异无显著性意义(P>0.05)；白膜法组和改良白膜法组较富含血浆法组残留红细胞和残留白细胞的量少，差异有显著性意义(P<0.05)，白膜法组与改良白膜法组比较，差异无显著性意义(P>0.05)。制备浓缩血小板的回收率受到全血量、离心转速、离心时间、离心方法等因素的影响。改良白膜法制备浓缩血小板减少红细胞和白细胞的残留量，提高了血小板的回收率，可在血液中心或中心血站推广应用。%BACKGROUND:Buffy-coat-derived platelet concentrates and plasma-rich platelet concentrates have a high incidence of invalid infusion and adverse reactions. OBJECTIVE:To observe the improved preparation of buffy-coat-derived platelet concentrates and to analyze the influential factors relevant to platelet recovery. METHODS:400 mL of blood sample extracted from 126 cases were randomly divided into improved buffy-coat group, buffer-coat group and platelet-rich plasma after 4-6 hours. The 3-step centrifugal method was used for improved preparation of buffy-coat-derived platelet concentrates:step 1, centrifugation at 2 300 r/min for 12 minutes at (22±2)℃ with a deceleration of 5;step 2, centrifugation at 910 r/min for 10 minutes at (22±2)℃;step 3, centrifugation at 2 800 r/min for 12 minutes at (22±2)℃. After centrifugation, the upper layer containing few platelets was removed, and the rest 30 mL platelet suspension was platelet concentrates. Factors affecting platelet recovery were analyzed through literature retrieval. RESULTS AND CONCLUSION:There was no difference in platelet number among the three groups before preparation of platelet concentrates (P>0.05). A higher rate of platelet recovery was found in the platelet-rich plasma group and improved buffy-coat group compared with the buffy-coat group (P<0.05), but there was no difference between the former two groups (P>0.05). There were less residual red blood cells and white blood cells in the two buffy-coat groups than the platelet-rich plasma group (P<0.05), but there was no difference between the two buffy-coat groups (P>0.05). The recovery rate of prepared platelet concentrates was affected by the whole blood amount, centrifugal speed, centrifugation time and methods. Improved buffy-coat method for preparation of platelet concentrates can be generalized in blood centers or blood stations, because it can reduce residual red blood cells and white blood cells and increase rate of platelet recovery.