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目的 :比较采集血小板前后献血者血清甲状旁腺素、钙和磷的变化情况及采集前服用钙尔奇 D对枸橼酸盐中毒的预防作用。方法 :选择有枸橼酸盐中毒症状的献血者 1 0例 ,第 1次采集血小板前不补钙 ,第 2次采集前 4 d开始服用钙尔奇 D6 0 0咀嚼片 ,1片 / d,观察是否出现枸橼酸中毒症状。同时测定两次采集前后血清甲状旁腺素、钙和磷的浓度。结果 :第 1次采集血小板过程中 ,1 0例均出现不同程度的枸橼酸盐中毒症状 ,占 1 0 0 %。而第 2次在采集血小板整个过程中 ,1 0例均未出现枸橼酸盐中毒症状 ,差异显著。两次采集血小板前后 ,1 0例血清甲状旁腺素浓度均明显升高 ,差异显著 (P<0 .0 1和 P<0 .0 5 )。第 1次采集前后血清甲状旁腺素浓度升高比第 2次明显 ,两组间有显著差异 (P<0 .0 5 )。结论 :采集血小板过程中 ,采用 ACD- A抗凝剂抗凝时 ,可引起甲状旁腺素浓度的升高。采集前补钙 ,能有效地预防枸橼酸盐中毒。
Objective: To compare the changes of serum parathyroid hormone, calcium and phosphorus in blood donors before and after platelet collection and the preventive effect of taking Calcium D before taking citrate intoxication. Methods: One hundred and twenty blood donors with symptom of citrate poisoning were selected. Before the first platelet collection, no calcium was added. Four days before the second collection, Observe the symptoms of citrate poisoning. Simultaneous determination of serum parathyroid hormone, calcium and phosphorus concentrations before and after the two acquisitions. Results: During the first platelet collection, 10 cases showed symptoms of citrate poisoning, accounting for 100%. The second in the whole process of collecting platelets, 10 cases did not appear symptoms of citrate poisoning, the difference was significant. Serum parathyroid hormone concentrations were significantly increased in 10 cases before and after two platelet acquisitions, with significant differences (P <0.01 and P <0.05). Serum parathyroid hormone levels increased significantly before and after the first harvest compared with the second, with significant differences between the two groups (P <0.05). CONCLUSION: In the process of collecting platelets, anticoagulation with ACD-A anticoagulant can cause the increase of parathyroid hormone concentration. Pre-collection of calcium, can effectively prevent citrate poisoning.