标准化干预方式预防柠檬酸盐抗凝剂对血小板捐献者骨代谢的影响

Effects of citrate anticoagulation on markers of bone metabolism of the platelet donor volunteers under the standardized intervention

目的探讨标准化干预方式预防柠檬酸盐抗凝剂对单采血小板捐献者机体骨代谢平衡的影响,为该干预方式的临床广泛应用提供实验依据。方法 43名机采血小板志愿者,随机分为2组,其中25名捐献者为标准化干预组,另外18名捐献者为未干预组,采用捐献血小板前后对比研究的模式,在口服钙片前抽血1次,采集血小板后30min再抽血1次,对血小板捐献前后的血样进行骨代谢标志物碱性磷酸酶(ALP)、总钙(Ca)、磷(P)、总I型胶原氨基端延长肽(T-P1NP)、β-胶原特殊序列(β-CL)、N-MID骨钙素(N-MID)、甲状旁腺激素(PTH)的综合检测。结果未干预组血小板捐献者,单采血小板前后ALP、T-P1NP、N-MID结果无明显差异(P>0.05),Ca2+、P、β-CL和PTH结果存在明显差异(P<0.05);标准化干预血小板捐献者,单采血小板前后Ca2+、ALP、T-P1NP、N-MID结果无明显差异(P>0.05),P、β-CL和PTH结果存在明显差异(P<0.05);经对比检测分析,捐献血小板后,未干预组和干预组ALP、T-P1NP、N-MID结果均无明显差异(P>0.05),Ca2+、P、β-CL和PTH结果存在明显差异(P<0.05)。结论采用标准化干预方式口服钙剂和维生素D后,单采血小板捐献者献血后血清Ca2+、P、β-CL和PTH水平均得到较好恢复,该方式可有效保护血小板捐献者骨代谢平衡与骨质健康。

Objective To investigate the effects of citrate anticoagulation on markers of bone metabolism balance of the platelets donor volunteers under the standardized intervention,provide some possible clinical references for the platelets donor volunteers. Methods The research mode of before and after offering platelets was adopted. 43 healthy blood donor volunteers were divided into two groups,providing the standardized means of intervention for 18 healthy blood donor（intervention group）, without the standardized means of intervention for 25 healthy blood donor volunteers（Non-intervention group）. Drew blood before taking the calaium tablet and after offering platelets 30 minutes. Examined two blood samples of markers of bone metabolism and electrolyte ：alkline phosphatase（ALP）,total calaium（Ca）,phosphorue（P）,β-crosslaps（β-CL）,total type I collagen amino terminal extension peptide（T-P1 NP）,N-MID osteocalcin（N-MID）,parathyroid hormone（PTH）. Results ALP,T-P1 NP,N-MID in non-intervention group and Ca^2＋,ALP,T-P1 NP,N-MID in intervention group had no difference before and after plateletpheresis（P〉0.05）. Ca^2＋,P,β-CL,PTH in non-intervention group and P,β-CL,PTH in intervention group had significant differences before and after plateletpheresis（P〈0.05）. There was no difference in ALP,T-P1 NP,N-MID between intervention group and non-intervention group（P〉0.05）. Ca^2＋,P,β-CL,PTH between the two groups were significantly different（P〈0.05）. Conclusion With the standized means of internention（taking calcium tablets containing vitamin D and calcium carbonate）,there are better improvement for Ca^2＋,P,β-CL and PTH levels of donor platetets volunteers,which can effectively protect bone metabolism disorder and bone health.