Uchida K, Rackoff W R, Ohene-Frempong K, Kim H C, Reilly M P, Asakura T
Department of Pediatrics, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, 19104, USA.
Am J Hematol. 1998 Sep;59(1):5-8. doi: 10.1002/(sici)1096-8652(199809)59:1<5::aid-ajh2>3.0.co;2-t.
An important purpose of blood transfusion in patients with sickle cell disease is to improve arterial oxygen saturation (SaO2) and thereby reduce red cell sickling. To investigate the degree of improvement in SaO2 by blood transfusion, we determined the hemoglobin oxygen affinity, transcutaneous oxygen saturation (Tc-SO2), and pulse rate before and after automated partial exchange transfusion (erythrocytapheresis). In 13 patients with sickle cell disease who underwent 24 erythrocytapheresis procedures, the mean oxygen tension at half saturation (P50) was significantly reduced from 30.4 +/- 2.2 to 26.0 +/- 1.6 mm Hg (P< 0.01) immediately after exchange transfusion. Mean Tc-SO2 values increased from 96.2 +/- 2.8 to 98.5 +/- 2.1% (P< 0.01). Approximately 50% of the increase in Tc-SO2 after erythrocytapheresis could be explained by the increase in hemoglobin oxygen affinity. An increase in arterial oxygen pressure (PaO2) following erythrocytapheresis, suggested by the calculated PaO2 in this study, may explain some of the increase in Tc-SO2. We conclude that improvement in Tc-SO2 in patients with sickle cell disease resulted from changes in hemoglobin oxygen affinity as well as blood oxygen pressure following erythrocytapheresis.
对镰状细胞病患者进行输血的一个重要目的是提高动脉血氧饱和度（SaO2），从而减少红细胞镰变。为了研究输血对SaO2的改善程度，我们测定了自动部分换血术（红细胞单采术）前后的血红蛋白氧亲和力、经皮血氧饱和度（Tc-SO2）和脉搏率。在13例接受了24次红细胞单采术的镰状细胞病患者中，换血术后即刻，半饱和时的平均氧分压（P50）从30.4±2.2显著降至26.0±1.6 mmHg（P<0.01）。平均Tc-SO2值从96.2±2.8升至98.5±2.1%（P<0.01）。红细胞单采术后Tc-SO2升高的约50%可由血红蛋白氧亲和力的增加来解释。本研究中计算得出的红细胞单采术后动脉氧分压（PaO2）升高，可能解释了部分Tc-SO2的升高。我们得出结论，镰状细胞病患者Tc-SO2的改善是由于红细胞单采术后血红蛋白氧亲和力以及血氧压力的变化所致。
