【摘要】 目的 对市场上流通使用的血塞通注射液在溶血性方面的状况进行考察与研究。 方法 按《中国药典》2005年版一部附录ⅩⅧ B中药注射剂安全性检查法应用指导原则和中药、天然药物刺激性和溶血性研究的技术指导原则，对11 个厂家共计27 批血塞通注射液每批次样品制备4 个浓度，进行溶血实验研究，并采用分光光度法（545 λ/nm）测定计算溶血率，比较各批次样品的溶血率。 结果 不同厂家甚至同一厂家不同批次的血塞通注射液溶血率存在一定差异。 结论 在临床使用中应注意用量，过量使用可能导致溶血引起的不良反应；同时，应注意溶血引起的临床不良反应的观测。【Abstract】 Objective To explore the hemolysis of Xuesaitong injection. Methods According to the Guiding Principles of safety tests on traditional Chinese medicine injection in Annex ⅩⅧ B, Chinese Pharmacopoeia, 2005 Edition 1, and Technical Guidelines of studies on the irritability and hemolytic activity of traditional Chinese medicine and natural medicine, a total of 27 samples of Xuesaitong injections (each sample was diluted into four concentrations) produced by 11 manufacturers had been examined. Spectrophotometry (545 λ/nm) was used to calculate the hemolytic rate. Results There was a certain difference in the hemolytic rate among several samples of Xuesaitong injections produced by different manufacturers, or even different batches by the same manufacturer. Conclusion The dosage of Xuesaitong injections should be noted in clinical use. Excessive use may lead to adverse reactions caused by hemolysis; at the same time, clinical adverse reactions caused by hemolysis should be observed.
【Abstract】 Objective To report 1 case of acute hemolytic anemia after liver transplantation because of ABO compatibility and therapeutic experience. Methods The patient with liver cancer underwent orthotopic piggyback liver transplantation on September 2010 after radiofrequency ablation of the tumors. The donor and recipient ABO blood types were type O and type A, separately. Acute hemolytic anemia occurred at 10 days after transplantation and hemoglobin decreased to 56 g/L. The bone marrow showed active hyperplasia; and myeboid∶erythroid was 0.52∶1. The immunosuppressants were used and type O washed red blood cells were transfused immediately. Results The general condition of the patient was improved; hemoglobin increased gradually and returned to 111 g/L at 34 days after liver transplantation. At 12 months of follow-up, hemoglobin was within normal range. Conclusion Using graft blood type washed red blood cells transfusion and immunosuppressants could be an effective therapeutic procedure in the patient with ABO compatility graft when acute hemolytic anemia occurrs.
Spectrophotometry is a simple hemolytic evaluation method commonly used in new drugs, biomedical materials and blood products. It is for the quantitative analysis of the characteristic absorption peaks of hemoglobin. Therefore, it is essential to select the correct detection wavelength when the evaluation system has influences on the conformation of hemoglobin. Based on the study of changes in the characteristic peaks over time of the hemolysis supernatant in four systems, namely, cell culture medium, phosphate buffered saline (PBS), physiological saline and banked blood preservation solution, using continuous wavelength scanning, the selections of detection wavelength were proposed as follows. In the cell culture medium system, the wavelength of 415 nm should be selected within 4 h; , near 408 nm should be selected within 4~72 h. In PBS system, within 4 h, 541 nm, 577 nm or 415 nm should be selected; 4~72 h, 541 nm, 577 nm or near 406 nm should be selected. In physiological saline system, within 4 h, 414 nm should be selected; 4~72 h, near 405 nm should be selected; within 12 h, 541 nm or 577 nm could also be selected. In banked blood preservation solution system, within 72 h, 415 nm, 540 nm or 576 nm should be selected.
ObjectiveTo investigate the clinical features, diagnosis, treatment and prognosis of pulmonary tumor thrombotic microangiopathy (PTTM).MethodsA patient with PTTM was reported. Literatures about PTTM searched by WanFang databases and PubMed were reviewed for its clinical characteristics.ResultsA 62-year-old female was admitted with chief complaint of dry cough, dyspnea and hemoptysis. Progressive dyspnea, pulmonary hypertension and hypoxemia occurred during hospitalization. Computed tomography angiography (CTA) of the lung excluded pulmonary embolism. Peripheral blood appearing a large number of late erythroblasts and erythrocyte debris and progressively decreasing platelets suggested that the patient suffer from thrombotic microvascular disease. CT showed widely metastatic lesions at the vertebrae and sternum. On the basis of above clinical characteristics, PTTM was diagnosed clinically. Although the patient accepted respiratory support therapy, anticoagulation therapy and resuscitation, she still died 5 days later after hospitalization. Literatures about PTTM with complete clinical information were reviewed. A total of 92 PTTM cases were reviewed and the main reasons of these patients admitted were progressive dyspnea and chronic cough. During hospitalization, they all suffered varying degrees of hypoxia, while radiological findings of the lungs lack specificity. No abnormal sighs were found by lung CTA. The results of ultrasonic cardiography or the Swan–Ganz catheter indicated varying degrees of pulmonary hypertension, some patients were proved with disseminated intravascular coagulation and/or microangiopathic hemolytic anemia. The definite diagnosis of PTTM depended on the histologic evidence which were often obtained from post-mortem examination, because many patients couldn’t tolerate the lung biopsy due to rapid aggravation. The treatment of PTTM included respiratory support therapy, anticoagulation therapy, antipulmonary hypertension and the chemotherapy of primary or metastatic tumour. The prognosis of PTTM was poor and almost all of the patients died in a short term, ranged from 48 hours to 3 months.ConclusionIf a patient with a history of cancer or evidence of cancer metastasis has hypoxemia and pulmonary hypertension but without abnormal lung CTA signs, PTTM should be considered.
Autoimmune hemolytic anemia (AIHA) is an autoimmune disease in which the life span of red blood cells is shortened by red blood cell autoantibodies. Due to immune intolerance and abnormal immune regulation, the hyperfunction of B lymphocytes produces too many red blood cell autoantibodies. Anti-CD20 monoclonal antibody is a second-line drug for warm antibody AIHA and first-line drug for cold antibody AIHA by reducing B lymphocytes. At present, the optimal dose of anti-CD20 monoclonal antibody in the treatment of AIHA has not been determined. There are no reports on the treatment of primary AIHA with second- or third-generation anti-CD20 monoclonal antibodies.