Analysis of haematological parameters of frequent plateletpheresis donations
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摘要: 分析频繁捐献单采血小板对献血者血细胞参数的影响。选择2019年1月至2019年12月捐献单采血小板在20次以上献血者78例，分析7项血细胞参数的变化，分别使用单因素方差分析与50例初次献血者比较，采用配对t检验比较第21次献血前与第1次献血前血细胞参数的变化。频繁单采献血者血红蛋白(Hb)、平均红细胞血红蛋白含量(MCH)、平均红细胞血红蛋白浓度(MCHC)明显低于首次捐献者(P < 0.001);捐献血小板1年大于20次献血者，与他们本年度第1次捐献血小板时比较，捐献第21次时Hb、红细胞(RBC)、红细胞比容(HCT)、MCHC明显下降，差异有统计学意义(P < 0.001);在频繁捐献血小板Hb下降的单采献血者中，RBC相关指标除RDW无明显变化，其余指标第21次捐献前均低于第1次捐献前，其中Hb、HCT、MCHC明显降低(P < 0.001)，RBC、MCH、平均红细胞体积(MCV)出现一定程度下降。PLT在第21次捐献前高于第1次捐献前，差异有统计学意义(P < 0.05)，其余相关指标差异无统计学意义。频繁捐献单采血小板可以使献血者Hb及部分相关指标降低，对于此类献血者，应该采取一定的干预措施，最大限度保护和保留献血者。Abstract: To analyze the influence of frequent donation of platelet apheresis on blood cell parameters of blood donors. From January 2019 to December 2019, 78 blood donors who had donated platelets more than 20 times were selected, and the changes of 7 blood cell parameters were analyzed. One way analysis of variance was used to compare with 50 first time blood donors. Paired test compared the changes of blood cell parameters before the 21st blood donation and before the first blood donation. The Hb, MCH and MCHC of frequent single blood donors were significantly lower than those of first time donors(P < 0.001), among those who donated platelets more than 20 times a year, compared with their first platelet donation this year, Hb, RBC, HCT and MCHC of the 21st time decreased significantly, with significant differences(P < 0.001); among the apheresis donors who frequently donated platelets and decreased Hb, the RBC related indicators had no significant changes except RDW, and the rest of the indicators before the 21st donation were all lower than before the first donation, especially Hb, HCT, MCHC decreased significantly(P < 0.001), and RBC, MCH, MCV decreased to a certain extent. PLT before the 21st donation was higher than before the first donation, the difference was statistically significant(P < 0.05), and there was no significant difference in other related indicators. Frequent donation of apheresis platelets could reduce the blood donor's Hb and some related indexes. For frequent apheresis blood donors with decreased Hb, certain intervention measures should be taken to protect and retain blood donors to the greatest extent.
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表 1 2组献血者RBC相关参数比较
X±S 组别 例数 RBC/(×1012·L-1) Hb/(g·L-1) HCT/% MCV/fl MCH/pg MCHC/(g·L-1) RDW/fl 频繁献血组 78 5.01±0.38 146.95±14.08 0.45±0.04 89.31±5.27 29.35±2.07 328.54±7.98 12.47±1.26 首次献血组 50 5.02±0.36 154.86±11.50 0.46±0.03 90.34±8.05 30.93±2.00 338.46±9.06 11.78±0.93 P 0.905 0.001 0.136 0.385 < 0.001 0.001 0.001 
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表 2 频繁单采献血者第21次与第1次捐献前RBC相关指标比较
X±S 时间 RBC/(×1012·L-1) Hb/(g·L-1) HCT/% MCV/fl MCH/pg MCHC/(g·L-1) RDW/fl 第21次献血前 5.01±0.38 146.95±14.08 0.45±0.04 89.31±5.27 29.35±2.07 328.5±7.98 12.47±1.26 第1次献血前 5.12±0.43 152.32±14.33 0.46±0.04 89.38±5.36 30.12±3.93 332.4±7.07 12.35±1.60 P < 0.001 < 0.001 0.007 0.890 0.070 < 0.001 0.501
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表 3 第21次与第1次捐献前比较Hb下降者RBC相关指标变化
X±S 时间 RBC/(×1012·L-1) Hb/(g·L-1) HCT/% MCV/fl MCH/pg MCHC/(g·L-1) RDW/fl 第21次献血前 4.94±0.39 141.18±13.31 0.43±0.04 87.65±5.54 28.68±2.16 327.11±8.11 12.73±1.36 第1次献血前 5.16±0.73 155.37±14.66 0.47±0.04 89.25±5.30 30.51±5.16 332.79±6.47 12.46±2.01 P 0.0120 < 0.001 < 0.001 0.019 0.027 < 0.001 0.452
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表 4 2组献血者PLT相关指标比较
X±S 组别 PLT/(×109·L-1) MPV/fl PCT/% PDW/fl 频繁献血组 278.10±56.32 7.86±0.72 0.22±0.42 12.75±2.06 首次献血组 280.98±39.90 7.65±0.68 0.22±0.33 12.10±1.78 P 0.754 0.100 0.717 0.069
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表 5 频繁单采献血者第21次与第1次捐献前PLT相关指标比较
X±S 时间 PLT/(×109·L-1) MPV/fl PCT/% PDW/fl 第21次献血前 278.10±56.32 7.86±0.72 0.22±0.42 12.75±2.06 第1次献血前 263.8±60.3 7.90±0.78 0.21±0.42 12.82±2.24 P 0.033 0.348 0.062 0.658
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表 6 第21次与第1次捐献前比较Hb下降者PLT相关指标比较
X±S PLT/(×109·L-1) MPV/fl PCT/% PDW/fl 第21次捐献前 287.32±60.67 7.90±0.75 0.22±0.04 12.85±2.27 第1次捐献前 267.71±59.46 7.98±0.77 0.21±0.05 13.06±2.19 P 0.047 0.420 0.075 0.316
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