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库存血浆胆碱酯酶水平测定及其临床意义

The Determination of Plasma Cholinesterase Level in Banked Blood and its Clinical Significance

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【作者】 盛慧球钟沛霖王秀芹马升弟金振良邹和建

【Author】 SHENG Hui qiu, ZHONG Pei lin,WANG Xiu qin,MA Shen di,JIN Zhen liang,ZOU He jian (1.Emergency Dept.,Tongji Hospital,Tongji University.Shanghai 200065,China; 2.Emergency Dept.,The Central Hospital of Jinhua,Zhejiang Jinhua 321000,China; 3.The Central Blood Bank of Jinhua,Zhejiang Jinhua 321000,China; 4.Dept. of Occupation Medicine,Hua Shan Hospital,Fudan University,Shanghai 200040,China)

【机构】 同济大学附属同济医院急诊科浙江省金华市中心医院浙江省金华市中心血站复旦大学附属华山医院风湿科 上海200065上海200065浙江金华321000上海200040

【摘要】 目的 观察库血保存天数与血浆胆碱酯酶 (cholinesterase,CHE)水平变化关系 ;探讨急性重症有机磷农药中毒 (acuteorganophosphoruspesticidepoisoning ,AOPP)抢救中合理选择用于换血疗法或者输入的血源。 方法 选取志愿供血者 1 0名 ,各抽取全血 2 0 0ml,完全按库血条件保存 ;逐日每份抽取血浆 2ml,快速测定血浆CHE值 ,重复2 1d ,血液中心当日抽血后即刻测定的血浆CHE值作为对照组。CHE测定用Roch公司的胆碱酯酶试剂盒 ,BeckManCx 9全自动分析仪测定。结果 库血保存天数为 1 1d以内与第 1 3天的血浆CHE值与对照组比较差异无显著性 (P >0 .0 5 ) ,1 2d以上的其他各组均显著低于对照组 (P <0 .0 5 ) ,且定基比均 <80 %。保存天数与血浆CHE值呈负相关 (r =- 0 .96 2 5 ,P <0 .0 1 )。曲线回归 y =0 .3835x3 - 1 0 .84 1x2 +3.0 1 2 9x +41 6 1 .4 ,R2 =0 .96 1 7。结论 随采血后库血保存天数的增加 ,血浆CHE值逐渐下降。在重度AOPP抢救中 ,以使用保留天数为 1 1d以内新鲜血浆为宜 ,尤以保存天数最短者为优。本报告为强调输入新鲜血浆 ,提供实验依据。

【Abstract】 Objective To study the relationship between the preservation days of banked blood and the altered plasma cholinesterase level with the aim of making proper selection of banked blood in the emergency treatment of acute organophosphorus pesticide poisoning (AOPP).Methods Ten healthy volunteers were included in this study from whom two hundred milliliters of whole blood was collected and stored exactly as the standard banked blood.Two milliliters between the plasma were collected from each blood sample for quick assay between the plasma cholinesterase.This procedure had been repeated for 21 days.The plasma cholinesterase value was determined on blood samples in Blood Center on the same day which served as a control.The cholinesterase value was determined with a kit of Roch Company and Beck Man Cx 9 automatic biochemical analyzer.Results It was found that there was no significant difference of plasma cholinesterase value in banked blood stored within eleven days and the control group or between the thirteenth day and the control group ( P >0.05),but the plasma cholinesterase values of the other experiment groups were all significantly lower than that of the control group ( P <0.05).And as compared with the control group,the relative ratio with fixed base was lower 80 percent after twelve days.It seemed that the preservation days were in negative correlation with the plasma cholinesterase value (r=-0.9625,P <0.01).The curvilinear regression equation was y =0.3835x 3-10.841x 2+ 3.0129 x+4161.4, R 2=0.9617.Conclusion With the increase of the banked blood preservation days,the plasma cholinesterase value decreased gradually.So in the emergency treatment of severe AOPP,it is advised to use the fresh plasma preserved within eleven days,the shorter the time preserved the better.This study provides the experimental basis for emphasizing transfusion of fresh plasma.

【关键词】 库血血浆胆碱酯酶杀虫药有机磷中毒
【Key words】 banked bloodplasmacholinesteraseinsecticidesorganophosphoruspoisoning
【基金】 国家科技部“十五”科技攻关基金资助项目(2 0 0 1BA70 4B0 6)
  • 【文献出处】 同济大学学报(医学版) ,Journal of Tongji University (Medical Science) , 编辑部邮箱 ,2004年04期
  • 【分类号】R446.1
  • 【被引频次】3
  • 【下载频次】60
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