探讨淋巴细胞的灭活能力及其对红细胞体外保存质量的影响

浆K+的漏出不同程度地高于对照组,21d辐照组保存到35dK+>30mmol/L,显著高于同期保存的0d辐照组,表明21d保存的血液辐照后不宜保存到35d。21d辐照组辐照后当天血浆K+显著低于同期保存的0d辐照组,表明辐照后保存造成K+的严重漏出。Moroff[7]报道K+的浓度与红细胞体内恢复相关不大(r=-0.38)。但有新生儿输入高K+红细胞致命的报道[10],高K+的血液输给特殊患者应慎重。Na+随保存时间延长辐照组显著低于对照组,辐照诱发保存期间K+、Na+的变化机制有待探讨。　　<BR>辐照对血液保存期间的pH值无影响,但0d辐照组的pH显著高于21d辐照组的原因可能与留样误差有关。　　<BR>综上所述,笔者建议采用35 Gy辐照21d保存前的血液并推荐辐照后当天输注,新鲜血液辐照后保存期不得超过一周。对儿科、大量输血及肝肾功能障碍的患者最好输注辐照当天的新鲜血液。</P> <p> </P> <p>参考文献<BR>1 Moroff G,Luban NLC.The irradiation of blood and blood compo-nents to prevent graft-versus-host disease: Technical issues andguidelines.Transfusion Medicine Reviews,1997,11(1):15<BR>2 李家增,王鸿利,韩忠朝主编.血液实验学.上海科学技术出版社出版,1997,260~261<BR>3 李家增,王鸿利,韩忠朝主编.血液实验学.上海科学技术出版社出版,1997,202~203<BR>4 Rubinstein A,Radl J,Cottier H ,et al.Unusual combined immunode-ficiency and syndrome exhibiting kappa-IgD paraproteinemia,resid-ual gut-immunity and graft-versus-host reaction after plasma infu-sion.Acta Paediatr Scand,1973,62(4):365<BR>5 Guidelines on gamma irradiation of blood components for the pre-vention of transfusion-association graft-versus-host disease. BCSHBlood Transfusion Task Force,1996,(3):261<BR>6 Suzuki Y,Seiyama A,Tateishi N,et al.Rheological evaluation of X-ray irradiated blood.Vox Sang,1993,64(3):139<BR>7 Moroff G,Holme S,AuBuchon JP,et al.Viability and in vitro prop-erties of AS-1 red cell after gamma irradiation .Transfusion,1999,39(2):128<BR>8 Soszynski M,Bartosz G.Effect of postirradiation treatment on theradiation-induced haemolysis of human erythrocytes.Int J Radiat Bi-ol,1997,71(3):337<BR>9 梁华钦,邓　晶,田兆嵩.γ射线辐照对血液质量的影响.中国输血杂志,2002,15(3):177<BR>10　Hall TL.Neonatal mortolity following transfusion of red cells withhigh plasma potassium levels.Transfusion,1993,33(7):606</P> <p>