Wang Zongkui, Liu Hua, Dou Miaomiao, Du Xi, Hu Jijun, Su Na, Wang Ya, Zhang Rong, Li Changqing
Institute of Blood Transfusion, Chinese Academy of Medical Science, Chengdu, China.
Tibet Autonomous Region Blood Center, Lhasa, Tibet.
PLoS One. 2017 Apr 21;12(4):e0176390. doi: 10.1371/journal.pone.0176390. eCollection 2017.
According to the international guidelines, fresh frozen plasma (FFP) is unanimously used to treat coagulation disorders. The quality of FFP is critical for the clinical transfusion. Till now, few studies have integratedly evaluated the differences of FFP from blood donors at between high altitude (HA) and low altitude (LA). Besides, there were no special quality standards for HA FFP in China.
Up to 41 HA (Lhasa, 3700 m) and 46 LA (Chengdu, 500 m) blood donors were included in our study to estimate the differences of FFP from HA and LA blood donors. The concentration of total plasma proteins, prothrombin time (PT), activated partial thromboplastin time (aPTT), thrombin time (TT), fibrinogen (Fbg), factor (F) II, FV, FVII, FVIII, FIX, FX, FXI, FXII, D-dimer, protein C (PC), protein S (PS), antithrombin III (ATIII) and von Willebrand factor antigen (vWF:Ag) were determined, respectively.
As compared with FFP of LA blood donors, the total protein content of HA blood donors showed a significant decrease (65.2±8.9 vs.57.2±6.3 g/L; p<0.001); PT, aPTT, TT were significantly increased (p<0.001); the levels of FII, FV, FVII, FVIII, FIX, FX, FXI, FXII and vWF:Ag were notably decreased (all p<0.05), whereas Fbg and D-dimer were dramaticly increased (p = 0.038). Additionly, in HA blood donors, vWF: Ag and FVIII:C of O-group was significantly lower (p<0.05) than that of non-O-group. It should be noted that FVIII:C of HA blood donors (0.64±0.10 IU/mL) was lower than the current Chinese quality requirements for FFP (≥ 0.7 IU/ml). No significant differences were observed in PC, PS and ATIII.
In general, our findings showed that the quality of FFP was significantly different between HA and LA blood donors, and the current Chinese quality requirements of FFP are not suitable for HA FFP. Therefore, setting up a special quality requirement for HA is quite necessary and meaningful.
根据国际指南，新鲜冰冻血浆（FFP）一直被用于治疗凝血障碍。FFP的质量对于临床输血至关重要。到目前为止，很少有研究综合评估高海拔（HA）地区和低海拔（LA）地区献血者的FFP差异。此外，中国尚无针对HA地区FFP的特殊质量标准。
本研究纳入了41名HA地区（拉萨，海拔3700米）和46名LA地区（成都，海拔500米）的献血者，以评估HA和LA地区献血者的FFP差异。分别测定了总血浆蛋白浓度、凝血酶原时间（PT）、活化部分凝血活酶时间（aPTT）、凝血酶时间（TT）、纤维蛋白原（Fbg）、因子（F）II、FV、FVII、FVIII、FIX、FX、FXI、FXII、D-二聚体、蛋白C（PC）、蛋白S（PS）、抗凝血酶III（ATIII）和血管性血友病因子抗原（vWF:Ag）。
与LA地区献血者的FFP相比，HA地区献血者的总蛋白含量显著降低（65.2±8.9 vs.57.2±6.3 g/L；p<0.001）；PT、aPTT、TT显著延长（p<0.001）；FII、FV、FVII、FVIII、FIX、FX、FXI、FXII和vWF:Ag水平显著降低（均p<0.05），而Fbg和D-二聚体显著升高（p = 0.038）。此外，在HA地区献血者中，O型血的vWF:Ag和FVIII:C显著低于非O型血（p<0.05）。需要注意的是，HA地区献血者的FVIII:C（0.64±0.10 IU/mL）低于中国目前FFP的质量要求（≥0.7 IU/ml）。PC、PS和ATIII未观察到显著差异。
总体而言，我们的研究结果表明，HA和LA地区献血者的FFP质量存在显著差异，中国目前的FFP质量要求不适用于HA地区的FFP。因此，制定针对HA地区的特殊质量要求非常必要且有意义。
