目的 评价自体血液回收对回收红细胞氧解离曲线和2,3-二磷酸甘油酸（2,3-diphosphoglycerate， 2,3-DPG）的影响。 方法 选择15例择期行非体外循环冠状动脉旁路移植术的患者。使用自体血液回收机收集和洗涤术中回收血液。测定和比较自体静脉血红细胞（时间点T1）和回收红细胞在回收即刻（时间点T2）、室温（21~24 ℃）贮存4 h（时间点T3）和低温（1~6 ℃）贮存24 h（时间点T4）的氧解离曲线（P50值，氧饱和度为50%时的氧分压值）和2,3-DPG的浓度。每个时间点皆采取1个血液样本用于检测上述指标并且根据时间点把所有血液样本分为4组（T1组、T2组、T3组和T4组）。 结果 T2组、T3组和T4组的P50值分别为（28.77±0.27）、（28.94±0.25）和（28.87±0.34） mmHg（1 mmHg=0.133 kPa），都显著高于T1组的P50值［（27.07±0.23） mmHg］，差异有统计学意义（P＜0.05）；和T2组比较，T3组和T4组的P50值都没有明显变化（P＞0.05）。T2组的2,3-DPG浓度［（18±7） μmol/g］明显高于T1组［（13±6） μmol/g］，差异有统计学意义（P<0.05）；T3组和T4组的2,3-DPG浓度分别为（15±12） μmol/g和（15±6） μmol/g，和T1组比较有所升高，但差异无统计学意义（P＞0.05）；T3组和T4组的2,3-DPG浓度和T2组比较，有所降低，但差异无统计学意义（P＞0.05）。 结论 回收红细胞的氧运载能力并没有受到自体血液回收技术的影响，回收红细胞即刻的氧运载能力优于患者自身静脉血红细胞，而且贮存在21~24 ℃ 4 h和1~6 ℃ 24 h并没有明显变化。
Ｏｂｊｅｃｔｉｖｅ To assess effects of intraoperative cell salvage on oxygen carrying capacity of salvaged red blood cells (RBCs) during cardiac surgery. Methods Fifteen patients undergoing off-pump coronary artery bypass grafting surgery were enrolled. Blood was collected and processed using a Dideco Electa device. The level of P50 and 2,3-diphosphoglycerate (2, 3-DPG) from venous RBCs (time T1) and salvaged RBCs (time T2) was measured. We also measured the changes of these indicators among salvaged RBCs at 4 h(storage at 21-24 ℃, time T3) and at 24 h(storage at 1-6 °C, time T4). One blood sample was taken at each time point and all blood samples were divided into four groups(T1 group, T2 group, T3 group and T4 group according to the time point). Results The P50 value of T2 group［（28.77±0.27） mmHg］（1 mmHg=0.133 kPa）, T3 group ［（28.94±0.25） mmHg］ ａｎｄ Ｔ４ group［（28.87±0.34） mmHg］ was significantly higher than the value of Ｔ１ group ［(27.07±0.23) mmHg］(P<0.05). Ｔｈｅ P50 value ｏｆ Ｔ３ ｇｒｏｕｐ ａｎｄ Ｔ４ ｇｒｏｕｐ did not change obviously compared with the value ｏｆ Ｔ２ ｇｒｏｕｐ （P>0.05）. The 2, 3-DPG value of Ｔ２ ｇｒｏｕｐ［（1８±７） μmol/g］was significantly higher than the value of Ｔ１ ｇｒｏｕｐ［(13±6) μmol/g］ (P<0.05). The level of 2, 3-DPG ｏｆ Ｔ３ ｇｒｏｕｐ［(15±1２) μmol/g］ and Ｔ4 ｇｒｏｕｐ［(15±６) μmol/g］ ｓｌｉｇｈｔｌｙ ｉｎｃｒｅａｓｅｄ ｃｏｍｐａｒｅｄ ｗｉｔｈ ｔｈｅ ｖａｌｕｅ ｏｆ Ｔ１ ｇｒｏｕｐ(P>0.05). Ｔｈｅ ｌｅｖｅｌ ｏｆ 2, 3-DPG ｏｆ Ｔ３ ｇｒｏｕｐ ａｎｄ Ｔ４ ｇｒｏｕｐ ｓｌｉｇｈｔｌｙ ｄｅｃｒｅａｓｅｄ ｃｏｍｐａｒｅｄ ｗｉｔｈ ｔｈｅ ｖａｌｕｅ ｏｆ Ｔ２ ｇｒｏｕｐ （P>0.05）． Conclusionｓ The oxygen transport function of salvaged RBCs at 0 h was not influenced by the cell salvage process and was better than that of the venous RBCs. At the end of storage, the oxygen transport function of salvaged RBCs did not change consequently.
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