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三级医疗保健中心血库血液储存期间溶血情况的研究

Study of Hemolysis During Storage of Blood in the Blood Bank of a Tertiary Health Care Centre.

作者信息

Arif Sayeedul Hasan, Yadav Neha, Rehman Suhailur, Mehdi Ghazala

机构信息

Department of Pathology, Jawaharlal Nehru Medical College, AMU, Aligarh, UP 202002 India.

出版信息

Indian J Hematol Blood Transfus. 2017 Dec;33(4):598-602. doi: 10.1007/s12288-016-0769-5. Epub 2016 Dec 24.

Abstract

The aim of RBC storage system in a blood bank is to counteract damage to the metabolic machinery and the membrane, to improve post-transfusion viability. In recent years, the need for strict control over the quality of blood has been emphasised. Such quality indicator includes extend of hemolysis and morphological changes of RBC during storage. This study was design to see extend of hemolysis and level of plasma lactate dehydrogenase (LDH) and plasma potassium, during processing and storage at different intervals under blood bank condition. Forty-six donors were selected and blood units were collected and stored under blood bank conditions. Mean plasma haemoglobin of stored blood was estimated by tetra methyl benzidine method (TMB) and percentage hemolysis was calculated on day 0, 1, 7, 21, 28, 35 and 42 days. Similarly plasma LDH and plasma potassium level was also assessed during storage. It was noted that free haemoglobin level and percentage hemolysis progressively increased with storage along with the level of LDH and potassium. However, extend of hemolysis did not exceed the permissible limit of 0.8% up to 42 days of storage. 15 blood bags which showed visual hemolysis on day 28 did not exceeded the threshold of 0.8% hemolysis, when interpreted by TMB method. It was concluded that TMB method is better than visual method for determination of hemolysis. The reduced hemolysis at this centre may be accounted for the use of additive solution SAGM (Saline, Adenine, Glucose, Mannitol) and DEHP (di-2-ethyl hexyl phthalate) as plasticizer in blood bags for storage.

摘要

血库中红细胞储存系统的目的是对抗代谢机制和细胞膜的损伤,以提高输血后的存活率。近年来,人们强调了对血液质量进行严格控制的必要性。此类质量指标包括储存期间红细胞的溶血程度和形态变化。本研究旨在观察在血库条件下不同时间段的处理和储存过程中红细胞的溶血程度、血浆乳酸脱氢酶(LDH)水平和血浆钾水平。选取了46名献血者,采集血液单位并在血库条件下储存。通过四甲基联苯胺法(TMB)估算储存血液的平均血浆血红蛋白,并在第0、1、7、21、28、35和42天计算溶血百分比。同样,在储存期间也评估了血浆LDH和血浆钾水平。结果发现,随着储存时间的延长,游离血红蛋白水平、溶血百分比以及LDH和钾水平都逐渐升高。然而,在储存42天内,溶血程度并未超过0.8%的允许限度。通过TMB法解读时,28天出现肉眼可见溶血的15个血袋的溶血率并未超过0.8%的阈值。得出的结论是,TMB法在测定溶血方面优于肉眼观察法。该中心溶血率降低可能是由于在储存血袋中使用了添加剂溶液SAGM(生理盐水、腺嘌呤、葡萄糖、甘露醇)和作为增塑剂的邻苯二甲酸二(2-乙基己基)酯(DEHP)。

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