Effects of long-term plateletpheresis on electrolytes and parathyroid hormone in blood donors
-
摘要: 目的 研究单采血小板过程中献血者血清钾、钠、氯、钙、镁和甲状旁腺素(parathyroid hormone，PTH)的变化情况及长期单采血小板对这些指标的影响。方法 随机筛选初次单采献血者15例(初次组)和长期单采献血者15例(长期组)，分别检测献血者在血小板采集0 min、30 min、结束时血液标本的血清钾、钠、氯、钙、镁和PTH浓度，分析比较2组献血者这些指标的差异。结果 采集过程中，2组献血者的血清钾、氯总体水平均呈下降趋势，在采集30 min和结束时分别与0 min比较，差异均有统计学意义(P < 0.01)；2组献血者的血清钠总体水平呈上升趋势，但长期组增长不明显(P>0.05)；2组献血者的血清钙、镁总体水平均呈先下降后回升趋势，在采集30 min时达到低值，长期组血清钙在30 min和结束时分别与0 min比较，差异均有统计学意义(P < 0.01)，但初次组血清钙水平变化不明显(P>0.05)；2组PTH总体水平均呈先明显上升后缓慢回落的趋势，均在采集30 min时显著增高(P < 0.01)。2组间血清钾、钠、氯、钙、镁在0 min、30 min、结束时比较，差异均无统计学意义(P>0.05)；2组间血清PTH水平在30 min时比较差异有统计学意义(P < 0.05)。结论 长期捐献血小板对献血者的血清钾、钠、氯、钙、镁未产生明显影响，但长期组的血清PTH在采集中的增长水平较初次组明显降低，应当受到采供血机构的重视。Abstract: Objective To study the changes of serum potassium, sodium, chloride, calcium, magnesium and parathyroid hormone(PTH) in blood donors during plateletpheresis and the effect of long-term plateletpheresis on these indexes.Methods A total of 15 initial plateletapheresis donors(initial group) and 15 long-term plateletapheresis donors(long-term group) at this site were randomly selected. Serum potassium, sodium, chloride, calcium, magnesium and PTH concentrations were measured in blood specimens from donors at 0 min, 30 min and at the end of platelet collection, respectively, and the differences in these indicators between the two groups of donors were analysed and compared.Results The overall serum potassium and chloride levels of the donors in both groups tended to decrease during the collection process, with statistically significant differences at 30 min and at the end of the collection compared to 0 min, respectively(P < 0.01); An overall trend of serum sodium levels in both groups of blood donors was increasing, but a non-significant increase in the long-term group(P>0.05); The overall serum calcium and magnesium levels of blood donors in both groups showed a tendency to decrease and then increase, reaching the low value during the collection process at 30 min. The differences in serum calcium in the long-term group were statistically significant at 30 min and at the end compared with 0 min, respectively(P < 0.01), but the changes in serum calcium levels in the initial group were not significant(P>0.05). Overall PTH levels in both groups showed a significant increase followed by a slow decline, and were significantly increased at 30 min of collection(P < 0.01). No statistically significant differences in serum potassium, sodium, chloride, calcium and magnesium between the two groups at 0 min, 30 min and at the end of the comparison(P>0.05); The difference in serum PTH levels between the two groups was statistically significant when compared at 30 min(P < 0.05).Conclusion Long-term platelet donation did not have a significant effect on serum potassium, sodium, chloride, calcium or magnesium in donors, but the long-term group had a significantly lower increase in serum PTH levels in the collection compared to the initial group and should be taken seriously by blood collection agencies.
-
-
表 1 长期和初次单采血小板献血者的一般资料
X±S 项目 长期组(n =15) 初次组(n =15) P 年龄/岁 41.33±9.11 34.93±8.65 0.058 体重/kg 79.53±9.25 72.27±12.33 0.079 采集时间/min 67.13±11.46 79.20±20.12 0.053 ACD-A使用量/mL 364.93±49.59 395.40±68.10 0.172 处理血量/mL 3 456.80±278.13 3 647.33±511.76 0.219 
下载: 导出CSV
表 2 长期和初次单采血小板献血者采集过程中血清钾、钠、氯的变化
mmol/L，X±S 采集时间 长期组(n =15) 初次组(n =15) 血清钾 血清钠 血清氯 血清钾 血清钠 血清氯 0 min 3.89±0.34 141.63±2.92 103.90±1.42 3.80±0.43 140.21±3.31 105.00±1.73 30 min 3.44±0.202) 141.79±1.87 102.58±1.812) 3.33±0.372) 142.28±2.491) 103.59±2.122) 采集结束 3.45±0.142) 141.87±2.74 102.59±1.712) 3.34±0.392) 142.18±2.691) 103.53±1.702) 与同组0 min比较，1) P < 0.05；与同组0 min比较，2) P < 0.01。
下载: 导出CSV
表 3 长期和初次单采血小板献血者采集过程中血清钙、镁的变化
mmol/L，X±S 采集时间 长期组(n =15) 初次组(n =15) 血清钙 血清镁 血清钙 血清镁 0 min 2.46±0.11 0.84±0.05 2.39±0.17 0.83±0.07 30 min 2.30±0.131) 0.81±0.061) 2.36±0.11 0.79±0.06 采集结束 2.34±0.101) 0.83±0.06 2.37±0.13 0.81±0.062) 与同组0 min比较，1) P < 0.01；与同组30 min比较，2) P < 0.05。
下载: 导出CSV
表 4 长期和初次单采血小板献血者采集过程中PTH的变化
pg/mL，X±S 采集时间 长期组(n =15) 初次组(n =15) 0 min 41.25±10.80 35.48±12.06 30 mim 153.62±35.111)2) 181.48±37.901) 采集结束 103.11±17.371) 117.14±32.581) 与同组0 min比较，1) P < 0.01；与初次组30 min比较，2) P < 0.05。
下载: 导出CSV
-
[1] 范恩勇, 孙海英, 戴超凡, 等. 多次单采成分献血者铁蛋白代谢及贫血相关指标水平变化研究[J]. 临床血液学杂志, 2022, 35(8): 552-555. https://www.cnki.com.cn/Article/CJFDTOTAL-LCXZ202208004.htm
[2] 赵玥. 频繁单采献血者血细胞参数分析[J]. 临床血液学杂志, 2022, 35(8): 598-601. https://www.cnki.com.cn/Article/CJFDTOTAL-LCXZ202208015.htm
[3] 叶盛, 傅强, 何晓露, 等. 口服葡萄糖酸钙对单采血小板过程中献血者血清钙、镁和甲状旁腺素的影响[J]. 中国输血杂志, 2018, 31(6): 620-623. https://www.cnki.com.cn/Article/CJFDTOTAL-BLOO201806014.htm
[4] Solanki A, Agarwal P. Comprehensive analysis of changes in clinically significant divalent serum cation levels during automated plateletpheresis in healthy donors in a tertiary care center in North India[J]. Asian J Transfus Sci, 2015, 9(2): 124-128. doi: 10.4103/0973-6247.162688
[5] Bolan CD, Greer SE, Cecco SA, et al. Comprehensive analysis of citrate effects during plateletpheresis in normal donors[J]. Transfusion, 2001, 41(9): 1165-1171. doi: 10.1046/j.1537-2995.2001.41091165.x
[6] 洪缨, 郑碧华, 孟文, 等. 单采血小板前后献血者血清甲状旁腺素及电解质的变化[J]. 中国输血杂志, 2007, 20(2): 113-114. https://www.cnki.com.cn/Article/CJFDTOTAL-BLOO200702006.htm
[7] 孙启俊, 傅强, 李翠萍, 等. 长期机采血小板献血者甲状旁腺素测定的意义[J]. 中国输血杂志, 2005, 18(6): 468-469. doi: 10.3969/j.issn.1004-549X.2005.06.005
[8] 王凯, 陈新, 伏长青, 等. 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[J]. 中国输血杂志, 2022, 35(3): 307-310. https://www.cnki.com.cn/Article/CJFDTOTAL-BLOO202203018.htm
[9] 黄文君. 机采血小板低钙反应的预防及处理[J]. 临床血液学杂志, 2017, 30(6): 452-453. https://www.cnki.com.cn/Article/CJFDTOTAL-LCXZ201706013.htm
[10] 褚晓凌, 郭永建, 陈颖. 柠檬酸盐抗凝剂对机体电解质和骨代谢的影响[J]. 中国输血杂志, 2010, 23(3): 227-230. https://www.cnki.com.cn/Article/CJFDTOTAL-BLOO201003040.htm
[11] 沈燕, 叶盛, 傅强. 献血频次对单采血小板献血者血清钙、镁和甲状旁腺素的影响[J]. 临床输血与检验, 2021, 23(4): 469-472. https://www.cnki.com.cn/Article/CJFDTOTAL-LSXY202104013.htm
-