OBJECTIVE:To investigate the effects of mild SARS-CoV-2 infection on hematological parameters of adult blood donors and the suitability of apheresis platelet donation, the changes of the hematological parameters in blood donors with mild infection of the SARS-CoV-2 Omicron variant strain were evaluated. METHODS:Seventy-two blood donors with mild COVID-19 symptoms who donated consecutive apheresis platelets for 3 times from December 2022 to January 2023, 42 cases among which were included in the infection-positive group, and 30 cases in the suspected infection group. Forty-two donors un-vaccinated against SARS-CoV-2, un-infected, and donated three consecutive apheresis platelets from October to November 2022 were included in the control group. The changes of blood routine testing in the positive group and the suspected infection group were retrospectively compared before (Time1) and after (Time2 and Time3) the onset of symptoms, three consecutive times (Time1, Time2, Time3) in the control group by repeated measures analysis of variance. The Bayesian discriminant method was used to establish a discriminant equation to determine whether the recent infection of SARS-CoV-2 occurred or not. RESULTS:Simple effect of the number times of tests in the positive and suspected infection groups was significant（ Finfection-positive group=6.98, P < 0.001, partial η2=0.79, Fsuspected infection group=4.31, P < 0.001, partial η2=0.70）. The positive group and the suspected infection group had lower RBC, HCT, and HGB, and higher PLT and PCT at Time2 compared to Time1 and Time3(P < 0.05). The positive group and the suspected infection group showes RDW-CV and RDW-SD at Time3 higher than Time1 and Time2 (P < 0.001). The simple effect of the number times of tests in the control group was not significant ( F=0.96, P =0.55, partial η2=0.34). The difference of the whole blood count parameters in the control group for three times was not statistically significant (P >0.05). We established a discriminant equation to determine whether the recent infection of SARS-CoV-2 occurred or not. The equation had an eigenvalue of 0.22, a canonical correlation of 0.43 (χ2=27.81, P < 0.001), and an analysis accuracy of 72.9%. CONCLUSION:The hematological indicators of RBC, HCT, HGB, PLT, PCT, RDW-CV and RDW-SD in blood donors who had infected with mild COVID-19 showed dynamic changes. The discriminant equation for whether they are infected recently with COVID-19 has a high accuracy rate.

目的 分析高校学生参加单采血小板成分献血情况,为高校成分献血者的招募保留提供依据.方法 回顾性分析福州市2014-2019年高校学生成分献血的变化趋势、月份分布和人口学特性,评估高校开展成分献血宣传活动效果.结果 2014-2019年高校学生成分献血的千人口献血率总体上升(趋势x2=309.02,P＜0.01);成分献血主要集中在每年3～6月,(人次占比38.4％,1 484/3 861)和9～12月(37.1％,1 434/3 861);与非高校人群相比,高校学生成分献血群体中女性(50.6％,519/1 025)、年龄18～24岁组(90.4％,927人)、初次捐献(92.3％,946人)、捐献1次者(50.3％,515人)占比较高(x2值=102.50、1999.73、363.20、58.46,P均＜0.01),高校学生血液检测不合格率也较低(0.4％,x2=6.03,P＜0.01);2017-2019年,开展专项成分献血宣传活动院校、医学院校和其他院校的初次成分献血学生数与2014-2016年比较,分别增长297.8％、106.7％和33.6％.结论 高校学生是安全成分献血的可靠来源,采取适宜宣传策略能提高献血率,同时应重视献血者的保留,以推动无偿献血事业可持续发展.

目的 探讨血细胞分离机单采过程抗凝剂和生理盐水错误连接的原因及有效预防措施,保障单采献血者的安全.方法 第1阶段2008年12月至2016年9月采用人工校核方法;第2阶段2016年10月至2020年10月采用人工和信息系统辅助双校核方法.行Fisher's Exact Test双侧检验,对比校核方法改进前后溶液连接错误发生率.结果 第1阶段单采过程溶液连接错误发生率为1.02/万;Amicus与Trima+Mcs@+血细胞分离机溶液连接差错率之间,P＜0.05;第1、2阶段总差错率比较,P＞0.05;第2阶段推行人工和信息系统双校核方法后,未再发生抗凝剂和生理盐水连接错误的情况.结论 采用人工和信息系统辅助双校核方法,可有效预防抗凝剂和生理盐水连接错误的发生.

Objective To explore the reasons for wrong connection between anticoagulant and normal saline solution during apheresis platelet donation, as well as the preventive measures, so as to ensure the safety of apheresis platelet donors. Methods Manual checking in the first phase (December 2008 to September 2016) was compared with double checking (manual checking plus information system) in the second phase (October 2016 to October 2020) via bilateral testing using Fisher's Exact Test to study pre-post-improvement differences. Results The incidence of solution connection errors during apheresis platelet donation in the first phase was 1.02/10 000, and the error incidence between Amicus and Trima + Mcs®+ blood cell separator was statistically significant (P<0.05). The total incidence of errors between the first and second phases was not statistically significant (P>0.05). After the performance of double checking in the second phase, no wrong connection of anticoagulant and saline solution occurred. Conclusion The double checking method assisted by manual and information system can effectively prevent the wrong connection between anticoagulant and normal saline solution.

目的 分析初次单采血小板献血者人群结构特征和影响因素,为献血者招募和保留提供策略依据.方法 对本中心2017-2019年初次单采血小板献血者2 094例的结构特征进行分类比较,按照性别、年龄、文化程度、献血次数等进行分类比较,分析献血不良反应、年龄、文化程度、初次单采量、体质量、性别、全血捐献史、职业等因素与献血者1年期再次捐献血小板的临床关系.采用多因素logistic回归分析分析影响初次单采血小板献血者1年内再次捐献的因素.结果 初次单采血小板献血者人数逐年增长,1年捐献1次的占53.0％,人均2.70次/年;其中男性占60.74％,多于女性;年龄以18～24岁年龄段居多,占41.02％;文化程度以专科及以上人群为主,占78.61％.初次捐献血小板＞1治疗量献血者1年内的再次捐献率(56.0％)高于捐献≤1治疗量者(43.0％),未发生献血不良反应者(48.0％)高于发生者(34.0％),25～34岁年龄段低于其他年龄段(42.10％),以上差异均有统计学意义(P＜0.05).专科及以上学历献血者1年内再次捐献率(48.5％)高于初中及以下学历(41.3％),差异有统计学意义(P＜0.05),但logistic回归分析显示学历高对再次捐献无明显促进作用(P=0.05).结论 动员及招募男性、18～24岁、专科及以上学历人群成为单采血小板献血者的成功率高,未发生献血不良反应、初次捐献＞1治疗量的献血者再次捐献血小板的几率高;对不同人群可采取针对性动员和保留措施,以扩大单采血小板献血人群.

目的 对便携式血液成分分离机(MCS+)由少白细胞血小板采集程序(LDP)升级至通用血小板采集程序(UPP)前后的数据进行分析比较,探讨程序升级的总体效果.方法 血小板采集数据比较采用自身对照的方式,选择MCS+程序升级前后1年内分别采用LDP和UPP捐献血小板的献血者为研究对象,以不同性别、不同采集量(1个和2个治疗量)分组,按照同一献血者分别采用2种程序捐献同样治疗量的采集过程进行数据配对分析,共计216人次(男110人次,女106人次).比较程序升级前后MCS+采集血小板的参数、质控结果及献血不良反应发生情况.结果 无论采集1个治疗量还是2个治疗量,2种程序相同性别比较,血细胞比容(HCT)、采前血小板计数、采后血小板计数、全血处理量差异均无统计学意义(P>0.05);而UPP血小板采集时间短于LDP,血小板收集效率高于LDP,柠檬酸盐抗凝剂(ACD-A)用量多于LDP,差异均有统计学意义(P<0.05).相同程序和采集量,不同性别比较,HCT差异有统计学意义(P<0.05),血小板采集时间、采前血小板计数、采后血小板计数、全血处理量、ACD-A用量、血小板收集效率差异均无统计学意义(P>0.05).2种程序血小板质控抽检情况、献血不良反应(迷走神经反应和枸橼酸盐反应)比较,差异均无统计学意义(P>0.05).结论 UPP与LDP比较,采集时间缩短,血小板收集效率提高,献血不良反应发生率和产品质控抽检情况无差异,值得推广使用.但要根据各地献血人群条件,设置合适的采集基础参数,以采集高品质产品,提升献血者采集过程舒适度.

目的 分析福州地区献血者(单采血小板)献血前检测不合格情况及影响因素,为单采献血者保留与招募提供指导方向.方法 收集福州地区2016-2018年单采血小板献血者献血前检测数据,统计分析5项不合格指标及其影响因素.结果 福州地区2016-2018年检测单采献血者28736人次,总不合格率7.9％;不合格率由高到低:转氨酶ALT(3.9％)＞白细胞计数WBC(1.6％)＞血红蛋白(Hb)/血细胞比容(HCT)(1.5％)＞乳糜(0.6％)＞血小板计数PLT(0.4％);男性献血者ALT、乳糜、PLT不合格率高于女性,女性Hb/HCT不合格率高于男性;初次献血者不合格率(13.1％)高于再次(≥2次)献血者(7.5％);55～60岁组不合格率较低(5.2％);献血前检测不合格发生后3个月内再次献血人次占比,由高到低依次为乳糜(82.5％)＞ALT(65.6％)＞WBC(62.3％)＞Hb/HCT(57.5％)＞PLT(44.4％).结论 单采献血者献血前检测中,男性ALT、女性Hb/HCT、及初次献血的不合格率较高,应关注他们对再次献血的影响,制定针对性的宣教和招募方案,以提高献血成功率.

目的 分析2016-2018年福州地区初次单采血小板献血者招募情况,为今后有针对性的招募工作提供参考.方法 收集2016-2018年本中心单采献血者的招募资料,分析各种招募方式的构成情况、成功率、未成功捐献的原因.结果 2016-2018年初次单采血小板捐献人数同比增长12％、12.6％,初次捐献人数占总采集人数比例分别为24.4％、26.4％、29.7％,呈上升趋势;不同招募方式的构成比较,单采献血点现场动员(56.6％)＞街头全血献血点招募(35.3％)＞捐献全血3个月后招募(5.1％)＞同伴招募(2.0％)＞高校宣传(1.1％),P＜0.05;成功率依次为单采献血点现场动员(87.6％)＞高校宣传(48.8％)＞街头全血献血点招募(44.7％)＞捐献全血3个月后招募(32.0％),P＜0.05;在初次捐献单采血小板人群中,男性人数高于女性(男性62.6％,女性37.4％),18-24岁献血者比例最高(36％),只献过1-2次全血的献血者更易动员成单采献血者;未成功捐献的原因主要为献血前健康检查不合格(27.3％)、工作忙没时间(23％)、对献血小板有顾虑(16％).结论 不同招募方式的成功率存在差异,需不断改进招募工作,以提高招募成功率,建立稳定、不断动态更新的单采献血者队伍,确保临床用血及无偿献血事业可持续发展.

目的 分析单采血小板献血者的电话招募情况,为下一步建立高效的招募和保留策略提供依据.方法 将单采血小板献血者分为3组进行电话招募献血,A组为距末次捐献单采血小板间隔3个月的单采献血者,B组为距末次捐献间隔l2个月的献血者,C组为距末次捐献间隔24个月的献血者,比较3组不同人群特征,包括献血间隔期、性别、年龄、累计单次次数的招募预约率,调查分析未再捐献的原因.结果 A、B、C组电话招募预约献血率分别达34.63％、24.11％、10％,经比较的差异有统计学意义(P＜0.05);男性、年龄＞25周岁、累计单采次数≥3次献血者的电话招募预约率明显高于女性、年龄≤25周岁,累计单采次数＜3次的献血者;排前5位预约不成功的原因有自约(不提前预约捐献时间)、没空、失去联系、医学原因暂缓献血、移居外地等.结论 年轻(≤25周岁)、女性、累计单采次数＜3次、献血间隔期＞12个月是提高保留率的重要目标人群;年长(＞25周岁)、男性、累计单采次数≥3次、献血间隔期≤3个月可列入应急献血者队伍.

目的 调查分析2015-2017年福州地区56～60岁单采血小板献血者的献血情况,为献血者的招募和保留工作提供指导依据.方法 收集本地区2015年1月-2017年12月单采血小板献血者的相关信息,按年龄分组,回顾性分析56～60岁献血者献血情况.结果 2015-2017年56～60岁献血者单采血小板献血人次占比保持增长;56～60岁组中男性献血者比例(76.89％)高于其他各组男性比例(除26～35岁组外),差异有统计学意义(P＜0.05);56～60岁多次献血者比例(49.58％)高于其他各组,56～60岁单次献血者比例(34 45％)低于其他各组,差异有统计学意义(P＜0.05);56～60岁献血者血液检测不合格率(0.19％)低于其他各组,差异有统计学意义(P＜0.05);DRVR比较,差异无统计学意义.结论 56～60岁年龄段献血者是安全低危的献血人群,可作为招募保留对象继续献血,该年龄段献血的增加对临床血小板供应起到补充作用.

目的 分析福州地区单采血小板献血不良反应分类分级情况及其相关影响因素,以期改进工作,减少不良反应的发生,促进献血者的保留.方法 根据《献血不良反应分类指南》(WS/T551-2017),对福建省血液中心2016-2017年期间发生的单采血小板献血不良反应进行分类分级和献血相关性评估,分析不良反应发生的相关因素及对再次献血的影响,结果采用x2检验进行统计学分析.结果 2016-2017年单采血小板共计17 207人次,发生献血不良反应573例,发生率3.33％,类型包括血肿(77.66％)、血管迷走神经反应(VR)(13.26％)、枸橼酸盐反应(6.63％)、神经刺激(0.70％)、手臂疼痛(0.70％)、其它(0.52％);均为非重度不良反应;与献血相关性的评估分级分别为1级占88.83％,2级占10.12％,3级占0.70％,4级占0.35％.血肿发生率方面,初次献血高于2次及以上献血(P＜0.01),不同性别、季节差异无统计学意义,血肿发生后献血者半年内再次献血比例85.84％.VR的发生率方面,不同年龄段的反应率有统计学差异(P＜0.05),18-23岁组发生率最高,女性高于男性,初次献血高于2次及以上献血(P＜0.01),反应发生后献血者半年内再次献血比例59.21％.枸橼酸盐反应的发生率方面,女性高于男性,初次献血高于2次及以上献血(P＜0.01),不同年龄段的反应率无统计学差异.反应发生后献血者半年内再次献血比例44.74％.结论 总体来说,女性、初次单采献血者献血不良反应发生率较高.对于VR,要更多的关注年轻的献血者,献血不良反应对献血者再次献血意愿有较大影响.有针对性的采取必要措施做好预防工作,改进采集过程服务,可减少献血不良反应的发生,促进献血者保留.

目的:分析单采血小板献血者血肿情况和发生原因,探讨血肿改进措施和电话再招募方式,以促进献血者的保留.方法:通过血液管理信息系统和现场登记的献血不良反应记录单,统计分析2017年福建省血液中心单采血小板血肿相关数据,对血肿发生后大于3个月未再次捐献单采血小板的献血者按照招募程序逐一电话再招募.结果:8 835例单采血小板献血者中,发生血肿257例(2.91％),男性初次献血者(16例)与男性重复献血者(173例)血肿比较差异有统计学意义(P＜0.05).在献血者血肿后未再次捐献的比较中:男性初次献血者(15例)与男性重复献血者(36例)比较;女性初次献血者(9例)与女性重复献血者(26例)比较;男性重复献血者(36例)与女性重复献血者(26例)比较,3组均差异有统计学意义(均P＜0.01).257例血肿主要原因按比例依次是采血人员采血技术欠佳113例(43.97％)、献血者血管条件欠佳57例(22.18％)、捐献过程手臂移动56例(21.79％);单采血小板血肿后未再次捐献的献血者电话再招募成功率为55.81％(48/86).结论:单采血小板血肿发生后对初次献血者和女性献血者献血意愿影响较大.针对血肿原因,提高工作人员穿刺技术,捐献过程中人性化的服务可减少血肿的发生.对单采血小板血肿后未再次捐献的献血者进行电话再招募,简便、易行、成功率高,有助于献血者的回召和保留.

Objective:To analyze the cause of the disposal of apheresis platelets,and explore the improvement measures to reduce the disposalrate and ensure the safety of blood.Method:Retrospective analysis was used to classify and analyze the data of apheresis platelet collection in Fujian blood center from 2011 to 2016.Result:A total of 48 605 cases of volunteer apheresis platelet donors were collected from 2011 to 2016 in Fujian blood center,and among which,637 cases were discarded.The total disposal rate was 1.311％.The disposal ratecaused by unqualified infectious index accounted for 63.1 ％ (402/637).The disposal rate caused by unqualified non infectious indicators accounted for 36.9％ (235/746).There was a significant difference in disposal rate between unqualified infectious index and unqualified non infectious indicators from 2011 to 2016(P＜0.01).The main disposal reasons were unqualified biochemical detection(ALT),followed by a small amount of blood,nucleic acid detection positive,syphilis positive,chylous blood,HBV positive,HCV positive,RBCs contamination,HIV positive,improper operation and blood expired.Conclusion:The results showed that blood donation propaganda,correct choice of blood donors,and the screening test before blood donation could ensure the quality of blood,reduce blood disposal,which should be continued tomaintain and strengthen.At the same time,targeted control measures can reduce the risk of transfusion transmitted diseases,but also can reduce unnecessary disposal,and have an important guidingsignificance and reference value for the donor recruitment and platelet collection in future.

Background: We explored the effects of repeated plateletpheresis on the platelet P-selectin expression and soluble P-selectin (sP-selectin) concentrations in platelet donors.Methods: Totally 289 platelet donors and 97 first-time whole blood (WB) donors were enrolled from the blood donor registry at the Fujian provincial blood center, China. The accumulative numbers of plateletpheresis in the last 2 y for participants were recorded, and the basal concentrations of platelet count, sP-selectin and total platelet P-selectin (pP-selectin) were determined.Results: Platelet donors had significantly higher basal concentrations of sP-selectin compared to WB donors (24.12 +/- 7.33 ng/mL vs. 20.74 +/- 5.44 ng/mL, P < 0.0001), with no difference in platelet count and pP-selectin concentrations. Increased numbers of platelet donation were correlated with a steady increase of sP-selectin (r = 0.18, P = 0.002). Multivariate regression analysis identified that the frequency of plateletpheresis is an independent factor for the rise of the sP-selectin concentration (t = 2.64, P = 0.009) while no association was found for pP-selectin and platelet count.Conclusions: Repeated plateletpheresis could result in an increased basal concentration of sP-selectin in blood donors whereas not an alteration in the concentrations of total platelet P-selectin. It remains to be determined whether this might be a consequence of endothelial activation or platelet activation or some other phenomenon. (C) 2016 Elsevier B.V. All rights reserved.

BACKGROUND Recent genome-wide association studies in Caucasians suggested that an association exists between the ABO gene locus and soluble levels of P-selectin (sP-selectin). However, it is unclear if the relationship corresponds to the phenotypic expression of ABO groups or is present in different ethnic groups. The aim of this study was to verify this observation at both genotypic and phenotypic levels in a healthy Chinese population.STUDY DESIGN AND METHODS The ABO blood groups were determined by both phenotypes and genotypes in 440 healthy Chinese Han volunteers, while P-selectin levels were evaluated for sP-selectin and total platelet P-selectin (pP-selectin).RESULTS ABO phenotyping and quantitative analysis of individual sP-selectin plasma levels were combined to demonstrate that individuals phenotypically expressing the A antigen have approximately 20% lower sP-selectin plasma levels than those carrying the B or O phenotype (p<0.0001), but that no difference exists between A and AB and between B and O phenotypes. Genotyping data revealed that the presence of the A gene could be attributed to the observed difference in phenotype comparison, with no difference between A/A, A/B, and A/O genotypes. There were also no associations between ABO blood groups, either phenotypes or genotypes, and pP-selectin levels.CONCLUSION This study demonstrated an association between sP-selectin levels and ABO groups in a Chinese Han population, implicating its generalizability to other ethnic groups. This finding will improve the understanding of the mechanism of ABO blood group-associated diseases.

Objective To study the distribution characteristics and regularity of ABO blood group genotype of Han population in Fuzhou.Methods From 12 January 2011 to 23 May 2011,a total of 450 Han blood donors who donated blood in Fujian Provincial Blood Center were selected in the study randomly.ABO genotype of all the donors was analyzed by polymerase chain reaction-sequence specific primer (PCR-SSP).Results In 450 unrelated individuals of Fuzhou Han population,five alleles of A1 (21.78％),A205 (0.67％),B (19.33％),O1 (32.78％),O2 (25.44％) were detected,but no O3 allele was discovered; twelve genotypes were found,consisting of A1O1 (14.00％),A1O2 (11.11％),A1A1 (4.22％),A1A205 (1.11％),BB (3.56％),BO1(12.00％),BO2 (10.44％),O1O1 (10.44％),O1O2 (18.67％),O2O2 (5.33％),A1B (8.89％),A205B (0.22％).The difference was not statistically significant between observed value and expected value in different genotypes (x2 =13.5339,P＞0.05).The genotype frequency distribution of this group was in good agreement with Hardy-Weinberg equilibrium.Conclusions Corresponding with ABO genotype,the distribution characteristics of ABO blood group in Fuzhou Han population was O＞A＞B＞AB,the ABO gene frequency distributions from high to low were O1,O2,A1,B,A205.A2 allele had its own characteristic,dominated by A205. Key words: Han population; ABO blood group; PCR-SSP; Genotype

目的：调查分析福州市2013年机采献血者人群现状,为下一步献血者招募和保留工作提供依据。方法将机采献血者分为两组,A组：2013年仅捐献1次的机采献血者；B 组：2013年捐献2次及以上的机采献血者。查询本中心CAABB输血服务标准化系统进行数据统计,应用 SPSS 19.0软件做统计学分析。随机选择2013年仅捐献1次的部分机采献血者通过短信方式调查未再次捐献原因。结果机采献血者人群总体男性多于女性,以18~40岁年龄段为主,血型分布为O>A>B>AB,以自由职业者、职员居多。A、B两组性别、年龄、职业方面明显不同。B组男性比例>A组,B组年龄中位数、自由职业者、职员比例>A组,而学生比例<A组。2013年仅捐献1次的机采献血者占54.09%,年献血频率的中位数仅为1次。人均年献血频率为3.15次,机采血小板采集双份率64.92%。机采血小板献血者未再次捐献血小板原因前3位为：工作忙没时间、捐献过程时间太长、担心有损健康。结论福州市机采血小板献血人群在性别、年龄、职业、捐献频率方面存在结构不合理现象。应调整招募保留方式,建立一支稳固、结构合理的机采献血者队伍,以提高献血者的重复献血率、提高输血安全性,确保临床用血及无偿献血事业可持续发展。

Background: Citrate is the anticoagulation of choice in apheresis procedures. Citrate anticoagulation results in a short-term increase in serological markers of bone turnover, with uncertain clinical significance.Aim: To understand the effect of calcium supplementation on serological bone turnover markers during an acute citrate load as a mimic of citrate anticoagulation during apheresis procedures.Methods: A placebo-controlled, crossover study was conducted in 22 healthy volunteers. Volunteers received a standardized citrate load at a fixed dose of 1.5 mg/kg of body weight/min for 80 min for three times and a single placebo infusion as a control. Each intervention was separated by a wash-out interval of 2 to 3 weeks. During two citrate infusions, volunteers received an additional calcium supplementation, consisting of either oral administration of calcium carbonate or an i.v. bypass infusion of calcium gluconate. Serial blood samples were collected for the determination of ionized calcium (iCa), intact parathyroid hormone (iPTH) and markers of bone remodeling, C-telopeptide of type I collagen (CTX) and osteocalcin (OC).Results: The infusion of citrate without calcium supplementation resulted in an increase in the bone formation marker OC and the bone resorption marker CTX, in addition to the changes in iPTH and iCa. The administration of calcium by either oral administration or as an i.v, bypass infusion attenuated the observed changes in CTX, but showed no effects on the elevation of the bone formation marker OC. There was no difference in the attenuation of CTX between the two calcium formulations. However, the i.v. application of calcium gluconate had a superior effect in reducing the change of serum iPTH and iCa as compared to the oral administration of calcium carbonate.Conclusions: Calcium supplementation is an effective method in damping the citrate-related transient increase of the serological bone resorption marker CTX. As a mimic for the citrate-based apheresis procedure, our data may enforce the prophylactic application of calcium supplementation to attenuate the short-term elevation of bone resorption related to an acute citrate load. (C) 2011 Elsevier Inc. All rights reserved.

<正>伴随着临床成分输血的普及,机采血小板的应用得到了广泛认同,血小板的制备、保存及临床应用方面均取得了相当的经验与发展。但是,在机采血小板制备过程中,因乳糜血影响采集和造成血小板产品报废的情况常有发生。机采血小板工作人员对献血者的筛选、乳糜血的快速准确判定常存

Objective To investigate the possible effect of citrate on electrolyte metabolism in healthy people with different genders and races and provide a reference for the possible clinical interventions.Methods A cross over,placebo-controlled study was conducted in 22 age-matched Chinese(11 males and 11 females)and 10 male Caucasian volunteers after informed consents were obtained.Volunteers received of saline solution,separated by a wash-out period of two to three weeks.Serial blood and urine samples were collected during the observation period and analyzed for the selective biochemical parameters.Results Comparable basal levels of serum albumin[male(43.05±1.81)g/L vs female(42.26±2.67)g/L]and serum ionized calcium[male(1.27±0.04)mmol/L vs female(1.26±0.04)mmol/L]were observed between different genders of Chinese volunteers.However,citrate intervention led to more pronounced decrease of ionized calcium level in Chinese females compared to Chinese males[-28.68%(-20.00%--35.2%)vs-23.84%(-16.53%--29.32%),t=3.19,P ＜ 0.01].There was no differences of the levels of serum inorganic phosphate[-18.81%(-3.16%--25.09%)vs-19.23%(-1.22%--32.16%),t=0.36,P＞0.05]and albumin[-0.32%(3.27%--7.60%)vs 1.88%(6.03%--9.31%),t=0.47,P＞0.05].Independent of gender,citrate intervention resulted in an increased excretion of urine calcium in Chinese volunteers[before 0.34(0.09-0.87)vs after 0.96(0.18-1.47),t=6.66,P ＜0.01].Compared to Caucasian males,Chinese males has a higher basal level of serum ionized calcium [(1.27±0.04)mmol/L vs(1.22±0.02)mmol/L,t=3.7,P ＜0.01]and larger amplitude basal rhythm in serum albumin level[-11.72%(-5.70%--14.21%)vs-1.74%(2.43%--7.68%),t=7.43,P ＜ 0.01].Application of citrate resulted in comparable changes of serum ionized calcium [-23.84%(-16.53%--29.32%)vs-21.95%(-18.31%--30.92%)],phosphate[-19.23%(4.65%--32.16%)vs-12.68%(0.68%--42.19%)],albumin[-0.32%(1.05%--7.60%)vs-1.39%(1.87%--7.26%)]and urine calcium excretion[237.70%(11.8%-935%)vs 234.37%(5.45%-504.00%)]between Chinese and Caucasian males(t=0.32,0.03,0.25 and 0.04 respectively,P＞0.05).Serum levels of magnesium were not influenced in all volunteers during two interventions.Conclusions Independent of race and gender,the invention of citrate results in comparable changes of serum magnesium,inorganic phosphate and albumin.The effect of citrate on ionized calcium levels between genders implicates a higher risk for hypocalcemic reactions in females compared to males undergoing automatic apheresis procedures.