JP3177713B2 - How to store blood for transfusion or blood products - Google Patents

How to store blood for transfusion or blood products

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Publication number
JP3177713B2
JP3177713B2 JP11159992A JP11159992A JP3177713B2 JP 3177713 B2 JP3177713 B2 JP 3177713B2 JP 11159992 A JP11159992 A JP 11159992A JP 11159992 A JP11159992 A JP 11159992A JP 3177713 B2 JP3177713 B2 JP 3177713B2
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JP
Japan
Prior art keywords
blood
gas
transfusion
nitrous oxide
nitrogen
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Fee Related
Application number
JP11159992A
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Japanese (ja)
Other versions
JPH05305123A (en
Inventor
暢 佐藤
直人 岡崎
克己 日吉
和徳 川村
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Japan Science and Technology Agency
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Japan Science and Technology Corp
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Publication of JP3177713B2 publication Critical patent/JP3177713B2/en
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Description

【発明の詳細な説明】DETAILED DESCRIPTION OF THE INVENTION

【0001】[0001]

【産業上の利用分野】本発明は、輸血用血液または赤血
球製剤(以下、単に血液という)の保存方法に関する。
BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a method for storing blood for transfusion or a red blood cell preparation (hereinafter simply referred to as "blood").

【0002】[0002]

【従来の技術】従来、輸血用血液は、血液抗凝固剤とブ
ドウ糖等を含む保存液(たとえばCPD液)を収容し滅
菌した密封容器に採血され、そのまま冷蔵庫内において
大気中で4〜6℃の温度で保存されている。この状態で
保存された血液の使用期限は日本では採血後3週間と定
められている。現在ではその使用期限を延長させる工夫
が種々成されている。その一つにアメリカ合衆国などで
認可され利用されている従来の保存液に加えてアデニン
等の薬剤を添加する保存方法がある。また、本邦でも最
近MAP液による赤血球濃厚液保存が4〜6℃で6週間
まで認可された。しかし、これらの方法では長期にわた
る保存のために生じる溶血、すなわち、赤血球中のヘモ
グロビンが赤血球の破壊ないしは赤血球膜の変化により
赤血球より漏出してくることによって生じる血漿中遊離
ヘモグロビン濃度の上昇を防ぐことはできない。また、
この方法は、アデニンなどの添加物の余剰分またはその
代謝産物であるヒポキサンチンが、血液の生体注入の後
に副作用を引き起こすこともあり、改良すべき点を残し
ている。
2. Description of the Related Art Conventionally, blood for blood transfusion is collected in a sterilized sealed container containing a preservation solution (for example, CPD solution) containing a blood anticoagulant and glucose, etc., and is directly kept in a refrigerator at 4 to 6 ° C. in the air. Stored at the temperature. The expiration date of blood stored in this state is specified in Japan as three weeks after blood collection. At present, various measures have been made to extend the expiration date. One of them is a preservation method in which a drug such as adenine is added in addition to a conventional preservation solution approved and used in the United States and the like. In addition, in Japan, the preservation of erythrocyte concentrate with MAP solution has recently been approved at 4 to 6 ° C for up to 6 weeks. However, these methods prevent hemolysis caused by long-term storage, i.e., increase in plasma free hemoglobin concentration caused by hemoglobin in red blood cells leaking from red blood cells due to destruction of red blood cells or changes in red blood cell membrane. Can not. Also,
This method has a point to be improved in that the excess of additives such as adenine or its metabolite, hypoxanthine, may cause side effects after infusion of blood into a living body.

【0003】また、血液の凍結温度は約−2℃であり、
血液の保存温度をこの血液の凍結前まで下げて保存する
方法がある。この方法は、生体注入時の副作用は少なく
保存期間の延長を可能とするが、低温による障害に伴う
血漿中の遊離ヘモグロビンの増加(溶血)が観察され
る。この点に関して、本発明者らは、先に、現在臨床的
に輸液点滴薬の形で多用されているグリセリンとマニト
−ルを夫々少量づつ添加して、この低温による溶血障害
ならびに赤血球内外のナトリウム、カリウム等の電解質
の分配異常を防止、是正する方法を開発した(特公平2
−62534)が、なかには稀にその効果が予想された
ほどに期待できない低温障害に弱い血液も認められるた
めに、その原因の追及ならびに改良を重ねてきた。
[0003] The freezing temperature of blood is about -2 ° C.
There is a method of lowering the storage temperature of blood until it is before freezing and storing the blood. Although this method has a small side effect at the time of infusion into a living body and allows for a longer storage period, an increase in free hemoglobin (hemolysis) in plasma due to damage due to low temperature is observed. In this regard, the present inventors have previously added glycerin and manitol, which are currently in clinical use in the form of infusion drops, little by little, respectively, to prevent the hemolysis disorder due to this low temperature and sodium inside and outside erythrocytes. A method to prevent and correct abnormal distribution of electrolytes such as potassium and potassium.
-62534), however, since blood rarely suffers from low-temperature injury, whose effect is rarely expected as expected, has been found, and its cause has been investigated and improved.

【0004】[0004]

【発明が解決しようとする課題】本発明者等は、上述の
低温障害の主な原因を低温にするほど多くなる血漿中、
血液中の溶解酸素、特に活性酸素による障害との知見を
得た。すなわち、生体内を循環している血液は、肺で酸
素濃度を高められ活性酸素の曝露を受けるが、血液は自
身で保持している活性酸素に対する生理的防御機能によ
り、また、組織では酸素濃度自体が低下することによっ
て酸素による障害が通常(健康状態)では余り起こらな
いようになっている。しかし、低温状態で気体の溶解度
が増加する現象は保存血液に関しても例外ではなく、血
液中の酸素濃度は低温に成るほど増加する。しかし、酸
素に曝露される赤血球などの組織には、常に、SOD
(superoxide dismutase)やカタ
ラ−ゼなどの活性酸素除去酵素が多量に含まれており、
保存血液もこれらの働きを得るものとして酸素による障
害はほとんど無視されたいた。
SUMMARY OF THE INVENTION The present inventors have found that the main cause of the above-mentioned hypothermic injury is that the lower the temperature, the more plasma
It was found that there was damage due to dissolved oxygen in blood, especially active oxygen. That is, the blood circulating in the living body is exposed to active oxygen by increasing the oxygen concentration in the lungs, but the blood has a physiological defense function against the active oxygen held by itself, and the oxygen concentration in the tissue Due to the deterioration of itself, oxygen damage is less likely to occur normally (health condition). However, the phenomenon that the solubility of a gas increases in a low temperature state is no exception for stored blood, and the oxygen concentration in blood increases as the temperature decreases. However, tissues such as red blood cells exposed to oxygen always have SOD.
(Superoxide dismutase) and a large amount of active oxygen removing enzymes such as catalase,
Oxygen-induced damage was almost neglected, as stored blood also gained these functions.

【0005】ところが、本発明者等は、保存温度を従来
よりも下げた凍結前領域(0±2℃)での保存を研究、
具体的には0±1℃の領域で実験を実施した過程で、生
体内血液と異なり酸素を含んでいる必要のない保存血液
が保存期間中常に酸素を異常に多く含んだ状態に置かれ
ていることを見出し、SODなどの酵素の働きも低温に
なるほど低下することから従来の保存方法では酸素によ
る害を防止しきれないのではないかと考えた。そこで、
本発明者は、この酸素による障害を防ぐ手段として原因
物質である保存中の酸素の濃度を他のガスを用いて積極
的に低下させたところ、長期の保存に耐えることを見出
し、本発明を完成したもので、本発明の目的は輸血用血
液または赤血球製剤の長期にわたる液状保存方法を提供
するにある。
However, the present inventors have studied storage in a pre-freezing region (0 ± 2 ° C.) in which the storage temperature is lower than before, and
Specifically, in the process of conducting the experiment in the range of 0 ± 1 ° C., the stored blood which does not need to contain oxygen unlike the blood in a living body is always kept in an abnormally high state during the storage period. They found that the activity of enzymes such as SOD also decreased as the temperature became lower, so that the conventional storage method might not be able to prevent the damage caused by oxygen. Therefore,
The inventor of the present invention has found that, as a means for preventing the damage caused by oxygen, the concentration of oxygen during storage, which is the causative substance, is actively reduced by using another gas, and that it can withstand long-term storage. Once completed, it is an object of the present invention to provide a long-term liquid storage method for transfusion blood or red blood cell preparations.

【0006】[0006]

【課題を解決するための手段】本発明の要旨は、輸血用
血液または血液製剤を亜酸化窒素ガス、若しくは、亜酸
化窒素ガスと窒素との混合ガスの雰囲気下で保存するこ
とを特徴とする輸血用血液または血液製剤の保存方法で
あり、その際、輸血用血液または血液製剤をガス透過性
の良い容器内に収容し、亜酸化窒素ガス若しくは亜酸化
窒素ガスと窒素との混合ガスの雰囲気下で保存すること
が好ましく、更に、採血後、早期に輸血用血液または血
液製剤に含まれている酸素を下げるために雰囲気(環
境)を亜酸化窒素ガス若しくは亜酸化窒素ガスと窒素と
のガスでパ−ジすることが好ましい。
The gist of the present invention is to provide a blood or blood product for transfusion with nitrous oxide gas or acid.
A method for storing blood for transfusion or a blood product characterized by storing in an atmosphere of a mixed gas of nitrogen gas and nitrogen, wherein the blood or blood product for transfusion is stored in a container having good gas permeability. Containing , nitrous oxide gas or sub-oxidation
It is preferable to store in an atmosphere of a gas mixture of nitrogen gas and nitrogen, further blood after early blood for transfusion or atmosphere to reduce the oxygen contained in the blood product (environment) the nitrous oxide gas Or nitrous oxide gas and nitrogen
Be di preferred - path in the gas.

【0007】すなわち、本発明においては、保存中血液
の酸素障害を低減させるために、血液中の活性酸素を減
らすように空気を亜酸化窒素ガス若しくは亜酸化窒素ガ
スと窒素との混合ガスで置換し、血液の酸素濃度を低下
させて血液を保存するものであり、また、採血時または
採血直後に亜酸化窒素若しくは亜酸化窒素と窒素との混
合ガスを血液保存容器中あるいは血液保存容器の雰囲気
中に急速に大量に供給して、容器中あるいはその雰囲気
中の空気をパ−ジし、ついで、持続的に亜酸化窒素若し
くは亜酸化窒素と窒素との混合ガスを添加して大気中の
酸素が保存血液容器内に拡散浸透してくるのを防ぐ方法
を提供するものである。
That is, in the present invention, in order to reduce oxygen damage to blood during storage, air is supplied by nitrous oxide gas or nitrous oxide gas so as to reduce active oxygen in blood.
Is replaced with a mixed gas of nitrogen and nitrogen to reduce the oxygen concentration of the blood and preserve blood.In addition, immediately or immediately after blood collection , nitrous oxide or a mixed gas of nitrous oxide and nitrogen is used to preserve blood. rapidly large amount supplied to the atmosphere in the storage vessel or the blood storage container, the air or in the atmosphere in the vessel path - mixing and di, then the persistently nitrous oxide or nitrous oxide and nitrogen An object of the present invention is to provide a method of adding a gas to prevent oxygen in the atmosphere from diffusing and penetrating into a storage blood container.

【0008】次に、本発明について詳細に説明する。本
発明において輸血とは単に他人からの血液の供給に止ま
らず、手術前の自己血液の貯血からの供給をも言うので
あり、本発明において使用する亜酸化窒素とは笑気ガス
とも称されるものであって、該笑気ガスを用いる場合に
は、その麻酔作用による細胞膜の安定化、水分子との親
和性により低温での氷晶形成による障害を予防するなど
の作用も期待でき、特に血液の低温保存に関して効果が
よい。また、本発明において血液を保存する容器として
は、ガス透過性の良い容器が好ましく、該容器中に血液
を収容し、これを亜酸化窒素若しくは亜酸化窒素と窒素
の混合ガスで充満している雰囲気容器内に設置するこ
とによって、血液を収容した容器外から亜酸化窒素を拡
散浸透させ、保存中の血液酸素濃度の増加、及び、大気
中より血液内に浸透してくる酸素を抑制することができ
る。
Next, the present invention will be described in detail. In the present invention, blood transfusion means not only the supply of blood from another person but also the supply of blood from the autologous blood before operation, and the nitrous oxide used in the present invention is also called laughing gas In the case where the laughing gas is used, the effect of stabilizing the cell membrane by its anesthetic action, preventing the damage due to ice crystal formation at a low temperature due to the affinity with water molecules, and the like can be expected. It is effective for cold storage of blood. In the present invention, as a container for storing blood, a container having good gas permeability is preferable, and blood is stored in the container, and this is mixed with nitrous oxide or nitrous oxide and nitrogen.
By placing the filling to that atmosphere within the container with a gas mixture of blood is diffused penetrated the vessel or outside et nitrous oxide accommodate an increase in blood oxygen concentration in the saved, and the blood from the atmosphere Oxygen permeating into the inside can be suppressed.

【0009】本発明において血液を保存するに適したガ
ス透過性の良い容器とは0.02〜0.4mm程度の膜
厚を有するポリ塩化ビニ−ル、ポリオレフィン、ポリシ
リコン等のプラスチックフイルムまたはシ−トで構成さ
れているのであって、例えば、特公昭63−44374
号や特公平1−42214号に記載されている容器が好
適である。そして、これらの容器のガス透過率は、約6
500ml/m2・24hr・atm前後である。保存
血液の保存温度としては、−2℃〜+6℃程度の範囲、
好ましくは、0℃±1℃の範囲である。また、保存環境
中の血液の炭酸ガス濃度を調整、コントロ−ルすること
によって保存中の血液pH指数を、血液の代謝にとって
好ましい状態に保つことができる。通常、保存中の血液
の炭酸ガス濃度としては、保存1週間以後85mmHg
以下であり、保存中の血液pH指数としては、6.8〜
7.5の範囲にあることが好ましい。
In the present invention, a container having good gas permeability suitable for storing blood is a plastic film or sheet made of polyvinyl chloride, polyolefin, polysilicon or the like having a film thickness of about 0.02 to 0.4 mm. , For example, Japanese Patent Publication No. 63-44374.
And the container described in JP-B No. 1-42214 are preferable. The gas permeability of these containers is about 6
It is around 500 ml / m 2 · 24 hr · atm. As the storage temperature of the stored blood, a range of about -2 ° C to + 6 ° C,
Preferably, it is in the range of 0 ° C. ± 1 ° C. Also, by adjusting and controlling the concentration of carbon dioxide in the blood in the storage environment, the blood pH index during storage can be maintained in a state favorable for blood metabolism. Usually, the blood carbon dioxide concentration during storage is 85 mmHg after one week of storage.
The blood pH index during storage is 6.8 to
It is preferably in the range of 7.5.

【0010】次に、実施例をもって更に具体的に本発明
を説明する。
Next, the present invention will be described more specifically with reference to examples.

【実施例】対象血液は6名の健康成人男子から、CPD
液にグリセロ−ルとマニト−ル(最終濃度はそれぞれ
0.5、0.125W/V%)を含んだ膜厚380μm
医療用のPVC製通常容器と、膜厚130μmの医療用
PVC製薄膜容器とに、1名につき200mlずつ計4
00ml採血した。なお通常容器と薄膜容器の採血順序
は交互に替えて行った(クロスオ−バ−デザイン)。採
血当日の検査を行った後、薄膜容器血液は全容9lの金
属製容器に入れて笑気ガスで速やかに金属製容器内の空
気を置換した。薄膜容器血液はこの金属製容器を4〜6
ml/分の笑気ガスで換気しながら、通常容器血液(対
照群)と共に1±1℃に保たれた同じ冷蔵庫内で5週間
保存して比較を行った。なお換気に用いられた笑気ガス
は冷蔵庫外に直接排出することにより対照群に影響を及
ぼさないようにしてある。測定結果の一部を表1に示
す。なお、測定については、Student’s pa
ired t−testの統計的検定を用いた。危険
率;p<0.05として行った。
[Examples] Blood samples were collected from 6 healthy adult males using CPD.
Glycerol and manitol (final concentrations 0.5 and 0.125 W / V%, respectively) in the solution.
200 ml per person for a normal PVC container for medical use and a thin film container for medical use with a film thickness of 130 μm, each having a total of 4 ml.
00 ml of blood was collected. In addition, the blood collection order of the normal container and the thin film container was alternately performed (cross-over design). After the test on the day of blood collection, the blood in the thin-film container was placed in a metal container having a total volume of 9 l, and the air in the metal container was immediately replaced with laughing gas. Thin film container blood is 4-6
The comparison was carried out by storing for 5 weeks in the same refrigerator kept at 1 ± 1 ° C. together with the normal container blood (control group) while ventilating with laughing gas at ml / min. The laughing gas used for ventilation was directly discharged out of the refrigerator so as not to affect the control group. Table 1 shows a part of the measurement results. In addition, about the measurement, Student's pa
A statistical test of ired t-test was used. Risk factor; p <0.05.

【0011】[0011]

【表1】 [Table 1]

【0012】表1において、括弧内は単位、数値は平均
値および標準誤差(mean±SD)を表す。Stud
ent’s paired t−testを用いた統計
的検定の結果、5週間目の値は何れの項目についても対
照群との間に危険率5%以下で(p<0.05)有意な
差が認められた。 すなわち、本発明による保存方法
は、対照群と比べ酸素濃度の増加を抑制することにより
溶血と赤血球細胞膜の透過性の異常を抑え、また、グル
コ−ス値の低下や乳酸値の上昇といった変化は代謝がよ
り盛んに行われたことを示し、本来なら血液pHが代謝
量に相当して低下するべきところであるにも拘らず、現
行の3週間保存血液の平均pH6.6よりもはるかに高
く保たれており、さらに、電解質バランスもより好まし
い状態で保存されたことを示しているもので、本発明の
優位性を示すものである。
In Table 1, the unit in parentheses indicates the unit, and the numerical values indicate the average value and the standard error (mean ± SD). Stud
As a result of the statistical test using ent's paired t-test, the value at 5 weeks was significantly different from that of the control group in all items at a risk rate of 5% or less (p <0.05). Admitted. That is, the preservation method according to the present invention suppresses an increase in oxygen concentration as compared with the control group, thereby suppressing abnormalities in hemolysis and the permeability of erythrocyte membranes, and prevents changes such as a decrease in glucose level and an increase in lactic acid level. This indicates that metabolism was more active, and that the blood pH should be kept much higher than the average pH of the current 3-week stored blood, despite the fact that blood pH should drop in proportion to metabolism. It shows that the electrolyte balance was kept in a more favorable state, and also shows the superiority of the present invention.

【0013】[0013]

【発明の効果】以上述べたように、本発明によれば保存
中の溶血にともなう遊離ヘモグロビンの増加を抑制する
ことができ、従来よりも低い温度での血液保存を可能に
するもので、現行保存法よりも保存血液の質の向上を長
期間にわたって維持することができる。したがって本発
明による血液保存は貴重な保存血液を無駄にすることを
少なくする。また、自己血の術前貯血期間を長くするこ
とにより、良質の自己血を貯えやすくして他人からの血
液を使うに伴う輸血の副作用、合併症の減少に役立てる
ことができる。
As described above, according to the present invention, an increase in free hemoglobin due to hemolysis during storage can be suppressed, and blood can be stored at a lower temperature than before. It is possible to maintain the quality of stored blood for a longer period of time than the preservation method. Therefore, the blood storage according to the present invention reduces wasting valuable stored blood. In addition, by extending the preoperative blood storage period of autologous blood, it is possible to easily store high-quality autologous blood, which can be used to reduce the side effects and complications of blood transfusion caused by using blood from another person.

フロントページの続き (56)参考文献 特開 平2−74257(JP,A) 特開 昭59−33224(JP,A) 特開 昭63−60931(JP,A) (58)調査した分野(Int.Cl.7,DB名) A61J 3/00 A61K 35/14 Continuation of the front page (56) References JP-A-2-74257 (JP, A) JP-A-59-33224 (JP, A) JP-A-63-60931 (JP, A) (58) Fields studied (Int .Cl. 7 , DB name) A61J 3/00 A61K 35/14

Claims (3)

(57)【特許請求の範囲】(57) [Claims] 【請求項1】 輸血用血液または血液製剤を亜酸化窒素
ガス、若しくは、亜酸化窒素ガスと窒素との混合ガスの
雰囲気下で保存することを特徴とする輸血用血液または
血液製剤の保存方法。
[Claim 1] The blood for transfusion or blood products nitrous oxide gas, or storage method blood for transfusion or blood products, characterized in that stored in an atmosphere of a gas mixture of nitrous oxide gas and nitrogen.
【請求項2】輸血用血液または血液製剤をガス透過性の
良い容器内に収容し、亜酸化窒素ガス、若しくは、亜酸
化窒素ガスと窒素との混合ガスの雰囲気下で保存するこ
とを特徴とする輸血用血液または血液製剤の保存方法。
2. A blood or blood product for transfusion is housed in a container having good gas permeability , and nitrous oxide gas or acid
A method for storing blood for transfusion or a blood product, wherein the method is stored in an atmosphere of a mixed gas of nitrogen iodide gas and nitrogen .
【請求項3】採血後、早期に輸血用血液または血液製剤
の雰囲気ガスを亜酸化窒素ガス若しくは亜酸化窒素ガス
と窒素との混合ガスで空気又は酸素をパ−ジすることを
特徴とする輸血用血液または血液製剤の保存方法。
3. The method according to claim 1, wherein after the blood collection, the atmosphere gas of the blood for transfusion or the blood product is replaced with nitrous oxide gas or nitrous oxide gas.
Nitrogen mixed gas with air or oxygen the path of - storage method blood for transfusion or blood products and <br/> wherein the di child.
JP11159992A 1992-04-30 1992-04-30 How to store blood for transfusion or blood products Expired - Fee Related JP3177713B2 (en)

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