献血者在机采血小板术中电解质变化及对神经肌肉应激性影响

目的 了解献血者在机采血小板术中K^ ，Na^ ,Cl^-,Ca^2 变化，观察机体神经肌肉应激性改变。方法 随机选择进行机采血小板采集的献血者32人，在机采术中不同时段取血清样本测定K^ ,Na^ ,Cl^-,Ca^2＋含量，同时监测献血者神经肌肉应激性反应。结果 献血者在机采开始时K^ 升高，Na^ 、Cl^-、Ca^2＋变化差异无显著性，机采完成时K^ 、Ca^2 下降差异显著，和输入的ACD－A抗凝剂量呈高度负相关。整个机采术中，有9．37％的人感觉口唇麻木，女多于男，6．25％的人感觉四肢酸软无力，男女无差异，出现这种神经肌肉应激性改变的原因是献血者机采前的K^ 、Ca^2 血清水平明显低于反应正常者。结论 机采血小板术中机体K^ 、Ca^2 暂降低，能维持在正常生理水平内，对神经肌肉应激性的影响二者相互抵消，无异常表现，但机采前献血者K^ 、Ca^2 血清水平单项偏低接近生理，机采术中会导致机体神经肌肉应激性增高或降低，表现口唇麻木或四肢酸软，机采结束自行恢复。     

DSI-905电解质分析仪常见故障形成原因及排除方法

DSI-905电解质分析仪是上海迅达医疗仪器有限公司生产的钾（K^＋）、钠（Na^＋）、氯（Cl^-）、钙（Ca^2＋）、pH分析仪。它采用了离子选择电极，是一种化学传感器，能将溶液中某种特定离子的活度转变成电位信号，然后通过仪器来测量溶液中溶质的工作原理。该仪器体积小，耗电低，操作简单，测定快速，可直接准确测定未稀释的血清、血浆或全血中的K^＋、Na^＋、Cl^-、Ca^2＋、标准化离子钙（nCa^2＋）和pH值。自动化程度高，兼容全屏菜单提示的中文操作系统，是大、中、小型医院急诊和乡镇卫生院实验室不可缺少的好帮手。该仪器使用7年多来，总体运行正常。     

肝移植术中血气和电解质的监测

目的探讨肝移植术过程中不同阶段患者的血气及电解质变化规律,以便临床及时纠正。方法采用美国L-1400型血气分析仪对行肝移植术患者术中不同主要阶段的pH值、二氧化碳分压（PCO2）、剩余碱（BE）、氧分压（PO2）及钾（K^＋）、钠（Na^＋）、钙（Ca^2＋）浓度进行检测。结果pH值于无肝期30 min开始下降,至术终基本恢复正常;PCO2于下腔静脉开放后5 min平均升高3-6 mmHg;BE于无肝期下降,开放后个体间差值明显加大,约为-11-8;血K^＋开放后5 min波动在2.4-6.2 mmol/L;血Ca^2＋于麻醉后至开放后30 min均下降,但术终有所恢复。结论肝移植手术患者开放门静脉和下腔静脉后内环境明显紊乱,出现明显高CO2血症,而血Na^＋、血Ca^2＋、pH和BE均显著降低。血K＋和酸碱平衡的变化个体差异较大。     

口服葡萄糖酸钙对单采血小板献血者甲状旁腺素及钙、磷的影响

目的观察口服葡萄糖酸钙及不同口服方式对单采血小板前后献血者血清甲状旁腺素（PTH）及钙、磷浓度变化的影响。方法选择单采血小板献血者57名，分为未补钙组（n=26）、采前一次口服钙组（n=19）和采集过程中少量多次口服钙组（n=12），分别检测血小板采集前后血清PTH和钙、磷离子浓度。并选择献全血组20名。结果单采血小板后57名献血者血清中PTH浓度均明显升高，血清磷明显降低，与采集前比较差异有统计学意义（P〈0.05）；未补钙组与一次口服钙组单采前后PTH浓度升高的差异有统计学意义（t=2.167，P〈0.05）；未补钙组与少量多次口服钙组单采前后PTH浓度升高幅度的差异无统计学意义（t=0.403，P〉0.05）。单采组采前PTH浓度高于献全血组（t=2.083，P值均〈0.05），血清钙、磷的浓度低于献全血组（t值分别为2.069，2.162，P值均〈0.05），但仍在正常范围内。结论单采血小板前献血者口服一定的葡萄糖酸钙可以降低机采过程中血清PTH升高的幅度，但在血小板采集过程中少量多次口服钙并不能降低血清PTH升高的幅度。     

白细胞滤除对机采血小板质量的影响研究

本研究旨在评价白细胞滤除对机采血小板整体质量的影响。随机选取20单位单供者机采血小板在（22±2）℃条件下振荡保存24—96小时后使用血小板型白细胞过滤器进行过滤,分别检测机采血小板过滤前后的血小板浓度、平均血小板体积（MPV）、血小板单位容量、白细胞量、pH值、乳酸脱氢酶（LDH）浓度、K^＋浓度、血小板膜表面CD62p表达率、血小板凝血指数MA值,并计算白细胞去除率和血小板损失率。结果表明：机采血小板经白细胞过滤器过滤后,残留白细胞计数明显低于滤前白细胞计数（P〈0．001）,白细胞去除率达到了99．97％;血小板损失率为（8．1±4．2）％,明显低于20％的国家标准规定（P〈0．001）;与过滤前相比,过滤后MVP、机采血小板保存介质中的LDH浓度、K^＋浓度和pH值无明显变化（P〉0．05）,过滤后的血小板膜表面CD62p表达率出现轻度下降（P〉0．05）,但滤盘灌注液内血小板膜表面CD62p表达率却明显高于滤前（P〈0．05）;过滤后血小板MA值出现轻度下降,但无明显统计学差异（P〉0．05）。结论：使用白细胞过滤器可以有效去除机采血小板中混杂的白细胞及部分活化血小板,使血小板损失率控制在较低水平,且对于血小板凝血活性没有产生明显影响。过滤后的机采血小板达到预防巨细胞病毒感染及HLA同种免疫的质量要求。     

缩泉丸对肾阳虚多尿大鼠尿BUN、Cr、Na+、K+和Cl-离子浓度的影响

目的：观察缩泉丸对肾阳虚多尿模型大鼠尿BUN、Cr、Na^＋、K^＋和Cl^-离子浓度的影响。方法：用腺嘌呤250mg/kg灌服大鼠4周,造成肾阳虚多尿模型,分别给予缩泉丸、肾气丸和去氨加压素治疗4周,检测缩泉丸对尿BUN、Cr、Na^＋、K^＋和Cl^-离子浓度的影响。结果：模型组大鼠尿量比对照组大鼠明显升高,P〈0.01,dDAVP组、缩泉丸高剂量组大鼠尿量与模型组大鼠相比明显减少（P〈0.05）。肾阳虚多尿模型大鼠尿BUN、Cr含量比正常对照组明显降低（P〈0.01）、尿K^＋排出量比正常对照组明显减少（P〈0.05）、尿Na^＋、Cl^-排出量比正常对照组明显升高,P〈0.05;dDAVP组尿BUN含量比模型组明显升高,P〈0.05;dDAVP组尿和缩泉丸高剂量组尿K^＋排出量比模型组明显升高（P〈0.05）;肾气丸组、缩泉丸低、高剂量组尿Na^＋、Cl^-排出量比模型组明显减少（P〈0.01~0.05）。结论：缩泉丸能减少肾阳虚多尿模型大鼠尿量,增加肾阳虚多尿模型大鼠尿钾排出量、降低尿钠和氯排出量。     

血清K^＋、Na^＋、Cl^-、Ca^2＋正常参考范围与环境温度的关系探讨

目的：通过对健康体检者血清中K^＋、Na^＋、Cl^-、Ca^2＋浓度进行分析,探讨不同的环境温度与K^＋、Na^＋、Cl^-、Ca^2＋的正常参考值的关系。方法：对1 a中不同时间的环境温度下10 461例健康体检者血清中K^＋、Na^＋、Cl^-、Ca^2＋浓度进行检测。结果：不同的环境温度下Na^＋、CL^-浓度水平没有明显差异;K^＋、Ca^2＋浓度水平具有明显差异。结论：应建立不同温度下各种离子的正常参考值,可为临床提供更为准确的诊疗依据。     

血气分析仪、电解质分析仪与全自动生化分析仪三者所测电解质的比对分析

目的研究利用血气分析仪与电解质分析仪以及全自动生化分析仪测定血钾、血钠．血氯的相关性与偏倚,并探讨其差异。方法分别用OSMETECH OPTI CCA血气分析仪与康立AFT-300电解质分析仪及0LYMPUS AU2700生化分析仪对40例患者的动、静脉血样进行K^＋、Na^＋、Cl^-浓度的检测,对检测结果做统计学处理,观察三者结果差异有无显著性,并分析原因。结果康立AFT-300与OLIMPUS AU2700测定值间无显著性差异（P〉0．05）;康立AFT-300和OLYMPUS AU2700生化分析仪两者的测定值与OSMETECH OPTI CCA血气分析仪的测定值结果比较,其中,K^＋、Na^＋有显著性差异（P〈0．01）,Na^＋为显著增高,K^＋为显著降低,而Cl^-浓度则无显著性差异（P〉0．05）。结论同一实验室的检测系统应进行方法学对比和结果偏差评估,从而判断其临床可接受性,以保证检验结果的可比性。     

两种电解质分析仪检测结果的比较

[目的]通过对同一实验室不同电解质分析仪进行方法对比试验，探讨不同电解质分析仪结果的可比性。[方法]按照NCCLS《EP9-A2》文件要求，以美国贝克曼库尔特SYNCHRON CX3为对比方法，以Easylyte PLUS电解质分析仪为实验方法，用患者血清对钾（K^＋）、钠（Na^＋）及氯（Cl^-）进行检测，统计计算两方法间的相关系数和直线回归方程；然后以直线回归方程的斜率和截距校准Easylyte PLUS电解质分析仪，再用患者血清对K^＋、Na^＋及Cl^-进行检测，统计计算两方法间的相关系数和直线回归方程。[结果]校准前两分析仪K^＋、Na^＋及Cl^-检测结果差异有统计学意义（P〈0．01），校准后两分析仪K^＋、Na^＋及Cl^-检测结果差异无统计学意义（P〉0．05）。[结论]对同一实验室不同电解质分析系统应该进行方法对比实验，以确保其结果的一致。     

单采血小板前后献血者血清甲状旁腺素及电解质的变化

目的观察单采血小板前后献血者血清甲状旁腺素及电解质浓度的变化。方法选择单采血小板献血者45名,分为补钙组(n=11)和未补钙组(n=34),分别检测血小板采集前后血清甲状旁腺素(PTH)和钙、磷、钾、钠、镁离子浓度;献全血组(n=24)。结果单采后补钙组PTH浓度有统计学意义(t=2.472,P<0.05),未补钙组单采后磷浓度升高(t=3.191,P<0.05);单采血小板献血者采前血清磷、钙、钠的浓度低于对照组(t值分别为2.477,2.349和2.064,P<0.05),但仍在正常范围内。结论单采血小板会引起献血者血钙浓度短暂降低,但机体可自身迅速调节,不必常规补钙;单采血小板献血者采集前血清磷、钙、钠的浓度低于全血献血者。     

Is there neural control over electrolyte reabsorption in the human salivary gland?

A study was made of changes induced by cholinergic agonists and antagonists in the K+, Na+, Ca2+ and Cl- content of saliva of 22 human subjects with denervated parotid salivary glands. At all stages after denervation there was an increased content of Na+ and Cl- in the secretion of the denervated gland as compared with that of the control glands: after administration of pilocarpine and carbacholine; after administration of a combination of atropine and pilocarpine; in 'paradoxical' salivation induced by atropine, scopolamine, metacine or chlorosyle; in spontaneous secretion; in reflex secretion when this was partially restored. The concentrations of Na+ and Cl- in the secretion of the denervated gland were disproportionately higher than would have been expected from the raised salivation rate. Secretions from the denervated glands by virtue of their increased content of Na+ and Cl- resembled so-called primary saliva. The increased output of Na+ and Cl- and high concentrations of these ions in the secondary saliva after denervation indicates that there is loss of the normal neural control over reabsorption of electrolytes in the epithelium of the glandular ducts. Further, that absence of this control results in disturbances of membrane ionic transport, of membrane permeability and of the metabolism of the gland.     

On-line analysis of electrolytes in extracorporeally circulating blood: application of a rat model to examine the effect of a single pharmacological dose of melatonin on electrolyte levels in blood.

An experimental model was developed to study the kinetics of electrolytes under different physiological and/or pathological conditions. The model was applied to investigate in vivo the effect of a pharmacological dose of melatonin on the concentrations of Ca2+, K+, Na+, and pH in the anticoagulated blood of anaesthetized male Wistar rats (250-350 g). After the application of 0.25 mg melatonin/kg body weight, injected intraperitoneally into each of 8 rats, the electrolytes were measured by a flow-through system with highly sensitive ion-selective electrodes. The results were compared to a control group (n=8) which was treated with diluent (saline). The electrolytes were monitored continuously via an extracorporeal circulation, on-going for at least 60 min. Melatonin induced a significant increase of blood Ca2+ (p<0.02) by an average of 9.9% after 60 min. However, total calcium concentration did not increase significantly. The extracorporeal circulation provoked an elevation of K+ by hemolysis. This K+ increase was slightly diminished by melatonin (p<0.06). No melatonin effects were seen on Na+, pH and magnesium in blood and plasma, respectively. Also, the urine concentrations of the electrolytes were not altered by melatonin. The mechanism by which melatonin influences the blood concentrations of ionized calcium and potassium is not yet understood.     

Mechanism of action of Escherichia coli heat stable enterotoxin in a human colonic cell line.

Escherichia coli heat stable enterotoxin (STa) caused Cl- secretion across T84 cell monolayers in a dose-dependent manner only when applied to the apical membrane surface and not when applied to the basolateral surface. Measurement of cAMP, cGMP, and free cytosolic Ca2+ in response to STa suggested that cGMP alone mediated the Cl- secretory response. Studies utilizing blockers of the Na+,K+-ATPase pump, a Na+,K+,Cl- cotransport system, a K+ channel, and a Cl- channel suggest that all of them participate in the Cl- secretory process induced by STa. The results suggest that the Cl- secretory response induced by STa is mediated by cGMP after the enterotoxin binds to its receptor on the apical membrane. The enterotoxin, by increasing cGMP, opens a K+ channel on the basolateral membrane as well as a Cl- channel on the apical membrane. The activation of these ion exit mechanisms, together with activations of the Na+,K+,Cl- cotransporter and the Na+,K+-ATPase pump drives Cl- exit through the Cl- channel on the apical membrane.     

Hypercoagulable state induced by thrombocytapheresis

The influence of the continuous-flow automated blood cell separator, Fenwal CS-3000, on blood coagulation and the fibrinolytic system in blood donors was studied. Blood samples were taken from the collection line of donors undergoing extracorporeal circulation, before and after platelet pheresis. Of the molecular markers, prothrombin fragment-Fl + 2 (PFI + 2) markedly increased from 0.8 ± 0.3 to 2.9 ± 2.0 nM/ml (P < .004), thrombin antithrombin III complex (TAT) also markedly increased from 2.6 ± 1.3 to 56.0 ± 24.0 μg/L (P < .001), fibrinopeptide A (FPA) increased slightly from 0.8 ± 0.9 to 3.8 ± 4.2 μg/L (P < .05), and α2-plasmin inhibitor (α2-PI) decreased slightly from 95 ± 8 to 91 ± 9% (P < .05). In one donor with the highest level of PFI + 2, TAT, FPA, and plasmin inhibitor complex after platelet pheresis, protein C, protein S, C4b-binding protein, ATIII, plasminogen, α2-PI, and coagulation factors were decreased. In blood donors undergoing platelet pheresis using the continuous-flow automated blood cell separator, Fenwal CS-3000, a hypercoagulable state was observed. Changing the materials of the plastic disposables to a more thromboresistant material may prevent the hypercoagulable state in donors induced by platelet pheresis using the blood cell separator. © 1993 Wiley-Liss, Inc.     

连续血液净化治疗在妊娠合并急性肾衰竭中的应用观察

目的观察连续性血液净化治疗在妊娠合并急性肾衰竭的应用。方法18例妊娠合并急性肾衰竭的患者行连续性血液净化治疗,用前稀释连续静-静脉血液透析滤过(CVVHDF)治疗,观察治疗前后血尿素氮(BUN)、血肌酐(Scr)、电解质、血pH值、血常规、C反应蛋白(CRP)、APACHE Ⅱ评分,用放射免疫法测定治疗前、12h、24h、治疗后血液及废液中白介素6(IL-6)、肿瘤坏死因子α(TNF-α)水平。结果18例患者中,16例痊愈,1例死亡,1例转为慢性肾衰竭。治疗后血BUN、Cr较治疗前明显下降(P0.05);血电解质、血白细胞数及血pH值正常;CRP、APACHEⅡ评分、IL-6、TNF-α水平较治疗前下降,有显著差异(P0.05)。结论妊娠合并急性肾衰竭早期行连续性血液净化治疗疗效好,其机制明显降低IL-6、TNF-α水平,降低炎症反应,使抗炎因子和促炎因子趋于动态平衡。     

Studies on gel-filtered human platelets: isolation and characterization in a medium containing no added Ca2+, Mg2+, or K+.

We have adapted the gel filtration technique for separation of human platelets from the plasma constituents to permit use of an eluant containing no added Ca2+, Mg2+, and K+, and hence allow direct determination of the intracellular concentrations of these ions in the isolated platelets. The eluant employed is modified Ca2+-free Tyrode's buffer which contains Sr2+ (0.2 mM) as a substitute for Mg2+ and lacks added K+. The functional metabolic, and morphological properties of these isolated platelets have been determined ael-filtered platelets (GFP) to low concentrations of ADP and adrenaline was qualitatively similar to that of platelet-rich plasma (PRP). However, a slower response was observed for the GFP. This rate difference was partially or completely reversed by addition of apyrase to the medium. Analysis of the total adenine nucleotide content and the pattern of 14C incorporation into the metabolic adenine nucleotide pool indicated that isolation in this medium caused to significant change in the ATP and ADP contents or in the adenylate energy change in comparison with the PRP. However, a significant increase in the extent of hypoxanthine production from ATP was noted in GFP isolated in media lacking Mg2+. Inclusion of Mg2+ in the elution media prevented this increased hypoxanthine production. The intracellular concentrations of Ca2+, Mg2+, and K+ of the GFP as determined by atomic absorption analysis were in good agreement with the values obtained for platelets separated from plasma by high-speed centrifugation. Platelet Ca2+ and Mg2+ levels remained stable despite the lack of significant extracellular levels of these ions. However platelet K+ fell to about 30 per cent of its initial value after incubation of 90 minutes at 23 degrees C. and a coincident increase was observed in extracellular K+ concentration. This procedure for platelet isolation may be of particular value for studies on the role of Ca2+, Mg2+, and K+ in platelet physiology and metabolic processes.     

Reliability of IL Monarch ion-selective electrode module for sodium, potassium, and chloride measurements

We evaluated the IL Monarch random-access centrifugal analyzer for measurement of Na+, K+, and Cl- by an indirect potentiometric method. For different concentrations of control material, the total precision (CV) ranged between 0.82% and 1.14% for the three electrolytes; linearity was acceptable within a range of 103 to 215 mmol/L for Na+, 1.6-15.25 mmol/L for K+, and 80-173 mmol/L for Cl-. Data correlated well with those by flame photometry for Na+ and K+ and with those by coulometry for Cl-, both for various biological materials--sera, urines, dialysis fluids--and commercial control materials from various producers. Stability of the potentiometric signal was acceptable: daily variations were 0.2 mV for Na+, 0.05 mV for K+, and 0.03 mV for Cl-. Accordingly, we conclude that the system supplies reproducible and accurate results while being easy to use and requiring little maintenance. The use of indirect potentiometry offers results consistent with those obtained with traditional methods, and easily interpretable by clinical staff. However, better information about the actual ion activity in the tested sample for certain pathologies such as hyperlipemia and dysproteinemia could be obtained by methods involving direct potentiometry.     

全血于22℃保存24h分离制备悬浮红细胞及浓缩血小板的质量评价

目的 评价全血于22℃保存24 h分离制备悬浮红细胞及浓缩血小板的质量.方法 采用简单随机抽样法选择2014年5月至2015年2月广东省茂名市中心血站招募的60例献血者为研究对象.研究对象纳入标准:所有献血者献血前体检及相关血液学检查结果符合《献血者健康检查要求》(GB18467-2011)的相关规定.将60例献血者随机分为2组,每组各30例.两组献血者均分别采用五联采血袋采集全血各400mL,共计60袋全血.研究组献血者全血置于22℃保存和运输,并于采血后24 h制备悬浮红细胞和浓缩血小板.对照组献血者全血于22℃保存和运输,并于采血后8h内制备悬浮红细胞和浓缩血小板.两组献血者全血均采用白膜法制备悬浮红细胞和浓缩血小板.悬浮红细胞4℃保存至储存期末(制备后35 d),采用Bact/ALERT全自动微生物检测系统对其进行无菌试验;并比较两组悬浮红细胞的红细胞计数、血细胞比容(HCT)、血红蛋白(Hb)水平、游离血红蛋白(FHb)水平、储存期末溶血率,以及K+、Na+、C1-浓度.浓缩血小板22℃保存至储存期末(制备后5 d),采用Bact/ALERT全自动微生物检测系统对其进行无菌试验;并比较两组浓缩血小板的血小板含量、红细胞混入量、FHb水平、储存期末pH值、黏附率、聚集率及K+、Na+、C1浓度.结果 ①研究组与对照组悬浮红细胞储存35 d后,均无细菌生长;两组浓缩血小板储存5d后,均无细菌生长;②研究组与对照组悬浮红细胞储存35 d后,其血细胞比容(HCT)、血红蛋白(Hb)水平、储存期末溶血率均符合《全血及成分血质量要求》(GB18469-2012)的相关规定;两组悬浮红细胞的红细胞计数、HCT、Hb水平、FHb水平、储存期末溶血率及K+、Na+、Cl-浓度比较,差异均无统计学意义(t=0.55、0.51、1.18、0.48、0.72、2.86、2.07、2.40,P＞0.05);③两组浓缩血小板储存5d后,其血小板含量、红细胞混入量、储存期末pH值均符合《全血及成分血质量要求》(GB18469-2012)的相关规定;两组浓缩血小板的血小板含量、红细胞混入量、FHb水平、血小板黏附率、血小板聚集率,储存期末pH值,以及K+、Na+、Cl-浓度比较,差异均无统计学意义(t=0.17、0.16、0.56、2.43、0.36、2.50、1.85、1.75、0.32,P＞0.05).结论 22℃保存24 h制备的悬浮红细胞、浓缩血小板的质量符合国家标准,全血22℃保存过夜分离制备悬浮红细胞、浓缩血小板的方法可行.     

Protein does not interfere with the ion-selective electrode determination of calcium, sodium or potassium ions

The protein interference with the determination of ionised Ca2+, Na+ and K+ reported in several studies could be due to effects on liquid/liquid junction potentials or on the ion-selective electrodes, but could also be due to Donnan effects during sample preparation, e.g. ultrafiltration or dialysis. The possible interference of protein was studied by subjecting a bovine serum albumin solution, 100 g/l, to gel-filtration in Sephadex G-25 columns equilibrated with 150 mmol/l NaCl, 5 mmol/l KCl, 20 mmol/l MOPS, pH 7.4 and varying concentrations of Ca2+; 0.75 and 1.25 mmol/l. The albumin was dissolved in the basic electrolyte solution and pH adjusted before the gel-filtration. Samples were taken for measurements before, during and after the elution of the protein peak. In this way it was ensured that the activities were not changed by the presence of albumin. Also the temperature, the ionic strength of the electrolyte and the bridge solution were varied. Ca2+, Na+ and K+ activities were measured with the aid of a Kone Microlyte instrument and Ca2+ in addition with the Radiometer ICA-1 instrument or a measuring system consisting of a Philips IS 561-Ca electrode, a Beckman KCl reference electrode connected to the sample chamber via a 2% agarose bridge containing either 0.15 or 2 mol/l KCl, a pH/voltmeter and a voltage-bucking device. No interference by protein was found.     

碳酸钙口服片和碳酸钙咀嚼片对多次机采血小板男性献血者血清Ca2+和甲状旁腺激素水平的影响

目的 探讨碳酸钙口服片和咀嚼片对多次机采血小板男性献血者血清Ca2+和甲状旁腺激素(PTH)水平的影响.方法 采用简单随机抽样方法,选择2016年6月15日至7月15日,于深圳市血液中心捐献血小板的76例多次机采血小板男性献血者为研究对象.采用简单随机分组方法,将其分为3组:碳酸钙口服片组(n=27,机采前20 min口服碳酸钙D3片1片),碳酸钙咀嚼片组(n=25,机采前20 min口服碳酸钙D3咀嚼片1片)非未补钙组(n=24,机采前未服用任何补钙制剂).采用MCS+型血细胞分离机采集3组献血者血小板.并且分别于血小板机采前(机采前20 min),机采开始时,机采过程中(机采开始后约30 min),机采结束时,留取献血者静脉血5 mL.分别采用邻甲酚酞络合酮比色法和化学发光法,检测3组献血者的血清Ca2+和PTH水平.于血小板机采结束后,向碳酸钙口服片组和碳酸钙咀嚼片组献血者发放调查问卷,调查其对所服用碳酸钙制剂的满意度.采用统计学方法,比较3组献血者在血小板机采不同时间点的血清Ca2+和PTH水平,以及碳酸钙口服片组和碳酸钙咀嚼片组献血者对碳酸钙制剂的满意率.3组献血者一般资料比较,差异均无统计学意义(P＞0.05).结果 ①血小板机采前、机采开始时,3组献血者的血清Ca2+水平分别比较,差异均无统计学意义(P＞0.05).机采过程中,碳酸钙口服片组、碳酸钙咀嚼片组及未补钙组献血者的血清Ca2+水平分别为(2.26±0.06)mmol/L、(2.28±0.04) mmol/L和(2.24±0.06)mmol/L,3组比较,差异有统计学意义(F=3.47,P=0.04);碳酸钙口服片组与碳酸钙咀嚼片组,碳酸钙口服片组与未补钙组分别比较,差异均无统计学意义(P=0.08、0.36);碳酸钙咀嚼片组与未补钙组比较,差异有统计学意义(P=0.01).机采完成时,3组献血者的血清Ca2+水平分别为(2.25±0.06) mmol/L、(2.26±0.04) mmol/L和(2.17±0.05)mmol/L,3组比较,差异有统计学意义(F=21.29,P＜0.01);其中,碳酸钙口服片组和碳酸钙咀嚼片组比较,差异无统计学意义(P=0.56);但是均高于未补钙组,并且差异均有统计学意义(P＜0.01).②血小板机采前、机采开始时,3组献血者的血清PTH水平分别比较,差异均无统计学意义(P＞0.05).机采过程中,碳酸钙口服片组、碳酸钙咀嚼片组及未补钙组献血者的血清PTH水平分别为(110±21)pg/L、(102±26) pg/L和(161±40) pg/L;碳酸钙口服片组与碳酸钙咀嚼片组比较,差异无统计学意义(P=0.32);但是均低于未补钙组,并且差异均有统计学意义(P＜0.01).机采完成时,3组献血者血清PTH水平分别为(95±23)pg/L、(91±25)pg/L和(147±38)pg/L;碳酸钙口服片组与碳酸钙咀嚼片组比较,差异无统计学意义(P=0.09);但是均低于未补钙组,并且差异均有统计学意义(P＜0.01).③本研究共计发放调查问卷52份,均填写完整并收回.碳酸钙咀嚼片组献血者对碳酸钙制剂的满意率为92.0％(23/25),高于碳酸钙口服片组的59.3％(16/27),二者比较,差异有统计学意义(x2 =7.42,P＜0.01).结论 血小板机采前20 min口服碳酸钙咀嚼片,可使多次机采血小板男性献血者于机采过程中及机采结束后血清Ca2+和PTH水平保持稳定.碳酸钙咀嚼片口感良好,服用方便,可用于机采血小板献血者献血前使用.