Nifong Thomas P, Domen Ronald E
Department of Pathology, Penn State Milton S Hershey Medical Center, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA.
Ther Apher. 2002 Oct;6(5):390-3. doi: 10.1046/j.1526-0968.2002.00425.x.
Severe hypoxia occurs in patients with acute chest syndrome, and erythrocytapheresis has been shown to improve oxygenation. Patients with sickle cell anemia also have decreased baseline oxygen saturation values, but the effect of erythrocytapheresis on steady-state oxygenation has not been well studied. We investigated the changes in oxygen saturation versus hematocrit, fraction of hemoglobin A, and transfusion volume during 71 prophylactic erythrocytapheresis procedures performed in 5 stable patients with sickle cell anemia. Each patient had a history of either acute chest syndrome or stroke, but no serious events occurred while enrolled in the chronic exchange program. The oxygen saturation improved from 1% to 6% during erythrocytapheresis in each of our patients (p < 0.001) regardless of preprocedure saturation level or total hematocrit. We have shown that decreased baseline oxygen saturation in sickle cell disease is related to abnormal hemoglobin S levels, and oxygen saturation can be improved with erythrocytapheresis, independent of any change in the total hematocrit.
急性胸部综合征患者会出现严重缺氧，而红细胞单采术已被证明可改善氧合。镰状细胞贫血患者的基线血氧饱和度值也会降低，但红细胞单采术对稳态氧合的影响尚未得到充分研究。我们调查了5例稳定的镰状细胞贫血患者在71次预防性红细胞单采过程中血氧饱和度与血细胞比容、血红蛋白A比例及输血量的变化。每位患者都有急性胸部综合征或中风病史，但在参与慢性置换项目期间未发生严重事件。在我们的每位患者中，红细胞单采过程中血氧饱和度从1%提高到6%（p < 0.001），无论术前饱和度水平或总血细胞比容如何。我们已经表明，镰状细胞病患者基线血氧饱和度降低与异常血红蛋白S水平有关，并且红细胞单采术可改善血氧饱和度，而与总血细胞比容的任何变化无关。
