补钙干预对柠檬酸盐抗凝剂所致机体代谢变化的影响

Effect of Calcium Supplement on the Changes of Serum Analysis Induced by Acute Citrate Load (ACD-A)

[目的]了解不同补钙干预方式对柠檬酸盐抗凝剂(ACD-A)所致的机体代谢变化的影响,为预防ACD-A所致低钙血症提供参考。[方法]采用自身交叉、安慰剂对照研究模式,对22名志愿者分别给予4种干预:A.输注生理盐水为安慰剂;B.仅输注ACD-A;C.ACD-A输注+口服钙片;D.ACD-A输注+静脉补钙。每一干预过程中同时采样进行血、尿电解质分析。[结果]静脉补钙可有效减缓ACD-A所致的钙离子下降趋势;口服补钙仅明显提升干预末钙离子浓度。2种补钙方式均未对血磷的变化造成影响,但均导致游离钙、磷离子浓度恢复进程加快及24h后血磷检测值升高。B、C、D法干预模式下血磷与血钙的变化密切相关,血钾与血氯的变化相关。[结论]口服补钙和静脉补钙均对ACD-A所致的血钙和磷的代谢变化有影响。用口服钙剂预防时应考虑服用时间和剂量的影响。

[Objective] To study the effect of calcium （Ca） supplement on the changes of serum analysis induced by acute citrate （ACD-A） load for hypocalcemia prevention.[Methods] A crossover and placebo study were conducted and 22 volunteers were received for 4 interventions：A,placebo （saline）;B,ACD-A;C,ACD-A ＋ oral Ca;D,ACD-A ＋ intravenous （I.V.） of Ca.Serial blood and urinary samples were collected for analysis.[Results] I.V.Ca alleviated decreasing level of ionized calcium （iCa） in serum,while oral Ca only increased the iCa level at the end point of infusion.There were no effects on the changes of phosphate for both interventions,but expedited the recovery process of iCa and phosphate,and led to higher level of phosphate at 24 hours later.Changes of iCa and phosphate were correlated to each other for B,C,D interventions,while potassium was correlated to the chloride.[Conclusion] With oral and I.V.Ca supplements,there are effects on the levels of iCa and phosphate induced by ACD-A.Dose and time of administration should be taken into account to achieve the best effect by oral Ca supplement.