| Objective: To provide experimental data for the feasibility and security of intra-operative autotransfusion (IAT) in clinical appplication and to promote the clinical appplication of IAT, the effects of IAT on rheology properties of red blood cells were investigated and the rheology properties of blood salvaged by IAT and stored red cells were compared. The rheology properties of red blood cells were evaluated in all. Methods: Thirty ASA II-III patients who undergoing elective Spinal operation in general anesthesia were enrolled . All the patients had no hematologic diseases and cancer , all the patients'blood fat and electrolytes are normal. IAT was performed by the ZITI-2000 type autotransfusion system .Red blood cells were acquired before IAT from the operative field (Group S) and after IAT(Group H) ,the stored red cells in citrate-phosphate-dextrose-ademine (CPD-A) anticoagulant solution from 9 to 15 days are acquired(Group K), too. Deformation index---DImax an integral deformation index---IDI in hyperviscous medium,small deformation index---(DI)d.max and orientation index---(DI)or.max in low viscous medium were messured with laser diffractometer ,erythrocyte membrane fluidity was determined by spectrofluoroph meter and erythrocytes osmotic fragility was measured with spectrophotometer,the osmotic fragility curves were drawn.The ultrastructure of erythrocyte were observed under scanner electron microscope and the percent of nondiscocytes was counted . The secondary structures of amide I band of erythrocyte membrane protein was studied by Infrared Spectra. The quantitatives data were presented as mean±standard deviation,Paired t-rest was used to compare the differences of group H and group S;Two-sample t-rest was used to compare the differences of group H and group K,and the separate variance estimation t-test was used when the variances is unequal.One-way ANOVA was used to compared the differences of the percent of nondiscocytes . The rank sum test was used when the data were not nonnormal distribution. All the data were dealed with the statistical soft of SPSS11.5.P<0.05 was considered statistically significant. Results: The average ages is 62±12 years ,the rate of male and female is 1:1,the operation are Spinal Stenosis decompressio and Internal Fixators implantation. DImax(35±7),IDI(0.21±0.05),(DI)d,max(10±4),(DI)or,max(8±7) of Group S and (DI)or,max(10±8)of Group K are all lower than Group H( P<0.05), DImax,IDI,(DI)d,max,(DI)or,max of Group H are (43±5),(0.27±0.04),(12±5),(14±6);the osmotic fragility curve of Group S and Group K shifts right and the osmotic fragility curve of Group K shifts right more obviously.Morphology under scanner electron micrographshows that: the percent of Group H nondiscocytes is lower than both Group S and Group K (P<0.05).The erythrocytes of Group S are still discocyte erythrocytes to some extent,but some are swelled obviously and there are some tuber in some erythrocytes,which make the shape is unregular,some tissue particles are even seen , occasionally. The erythrocytes of Group H are still discocyte erythrocytes but a few erythrocytes are unregular erythrocytes, tissue particles are seen infrequently. Marked morphological change happens on the erythrocytes of Group K,there are a lot of unregular and echinocytes erythrocytes. Comparison with Group H in the degree of fluorescence polarization (p) and microviscosity (η),which means the microfluidity of membrane lipid bilayer of RBCs, there is no significient differnce between Group H and Group S, Group H and Group K(P>0.05). The secondary structures of amide I band of erythrocyte membrane protein studied by Infrared Spectra shows that: there is no significient differnce between Group H and Group S, Group H and Group K ( P>0.05). Conclusions: The deformability , osmotic resistibility and ultrastructure of Salvaged erythrocytes are superior to that of operative field erythrocytes and at the same time , The osmotic resistibility and ultrastructure of salvaged erythrocytes are better than that of stored red cells. In a word , the rheology properties of salvaged erythrocytes are superior to that of operative field erythrocytes and stored red cells in all, which is helped to...
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