献血间隔期不同补钙方式对单采血小板献血者部分生化指标的影响

How some biochemical indexes of apheresis platelet donors were affected by different calcium supplement methods at blood donation intervals

目的通过单采间隔期给予骨健康基本补充剂结合采血当日常规补钙和单纯单采当日常规补钙方式进行对比研究,探讨血小板捐献者给予2种不同口服补钙方式,改善因枸橼酸盐抗凝剂对机体部分生化指标的影响。方法选取2019年1月-2020年12月在本站长期固定捐献单采血小板的献血者252人,随机分为2组。实验组126人:除采血前常规给予10%葡萄糖酸钙口服溶液20 mL,口服。单采间隔期平均20±2 d给予口服钙尔奇D_(3)(含碳酸钙600 mg、维生素D3125国际单位),每日1粒;口服阿法骨化醇软胶囊(含阿法骨化醇0.25μg),每日1粒。对照组126人:采血前常规给予10%葡萄糖酸钙口服溶液20 mL,口服。2组献血者分别于单采血小板进针0 min、最后循环回输结束后0 min检测血清PTH和血清钙、镁、磷、25羟维生素D浓度,同时观察2组献血者采血小板过程中献血反应的发生。结果(1)实验组采血前与采血后相比较,采血后血清PTH浓度明显升高,血清钙、无机磷、镁、25羟维生素D均较采血前明显降低(P<0.01),有统计学意义。(2)对照组采血前与采血后相比较,采血后血清PTH浓度明显升高,血清钙、无机磷、镁、25羟维生素D均较采血前明显降低(P<0.01),差异有统计学意义。(3)采集后实验组中4人出现枸橼酸盐反应,不良反应发生率3.17%(4/126);对照组中8人出现枸橼酸盐反应,不良反应发生率6.34%(8/126)。(4)实验组采血前与对照组采血前相比较,血清钙浓度高于对照组,PTH浓度低于对照组(P<0.01),差异均有统计学意义,血清镁、无机磷、25羟维生素D浓度相比较无明显统计学差异(P>0.05)。(5)实验组采血后与对照组采血后相比较,血清PTH浓度低于对照组(P<0.01),血清钙高于对照组(P<0.01),均有统计学意义。血清镁、无机磷、25羟维生素D浓度相比较均无明显统计学差异(P>0.05)。结论单采间隔期中给予捐献者骨健康基本补充剂(钙+维生素D)结合单采当日常规补钙,较单纯单采当日常规补钙可以进一步减缓机采血小板后献血者血清PTH的升高和血清钙磷的降低,切实有效地减轻献血者枸橼酸盐反应,对长期频繁捐献单采血小板的献血者预防骨质疏松具有重要的意义。

Objective To investigate the effect of two different oral calcium supplementation methods(method 1:bone health basic supplements in the interval plus routine calcium supplement;method 2:only routine calcium supplement on the day of donation)on platelet donors,to improve some biochemical indexes of the body caused by citrate anticoagulant.Methods A total of 252 long-term regular platelet donors in our station from January 2019 to December 2020 were selected and randomly divided into two groups:experimental group(n=126)were given 10%calcium gluconate oral solution 20 mL before platelet collection,orally.Oral caltrate D3(containing 600 mg calcium carbonate and 125 international units of vitamin D_(3))was administered in the interval(20±2 days),1 tablet per day.Oral alfacalcidol soft capsule(containing alfacalcidol0.25μg),1 tablet per day;control group(n=126)were given routine administration of 10%calcium gluconate oral solution 20 mL before platelet collection.Serum PTH and serum concentrations of calcium,magnesium,phosphorus and 25hydroxyvitamin D of the two groups were detected at 0 min after injection and 0 min after the end of the last circulation,respectively.Meanwhile,the occurrence of blood donation reactions was observed in the two groups.Results In the experimental group and control group,serum PTH concentration both increased significantly after donation,while serum calcium,inorganic phosphorus,magnesium and 25 hydroxyvitamin Ddecreased significantly(P<0.01).After donation,4 donors in the experimental group and 8 in the control group showed citrate reaction,with the incidence of adverse reactions at 3.17%(4/126)and 6.34%(8/126),respectively.Before blood collection,serum calcium concentration in the experimental groupwas higher than that in the control group,while PTH concentration was lower than that in the control group(P<0.01),butno significant differences were noticed in serum magnesium,inorganic phosphorus and 25 hydroxyl vitamin D concentrations(P>0.05),and so was in the control group after blood collection.Conclusion Method 1 can further slow down the increaseof serum PTH and the decrease of serum calcium,and can effectively reduce the citrate response of blood donors comparedwith method 2,which is of great significance to prevent osteoporosis in long-term regular blood donors.