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.

Effects of calcium carbonate oral tablets and calcium carbonate chewable tablets on serum Ca2+ and parathyroid hormone levels in male regular plateletpheresis donors

Objective To investigate effects of calcium carbonate oral tablets and chewable tablets on serum Ca2+ and parathyroid hormone (PTH) levels in male regular plateletpheresis donors.Methods A total of 76 male regular plateletpheresis donors were selected by randomized sampling method from Shenzhen Blood Center from June 15 to July 15,2016.They were divided randomly into 3 groups by simple random grouping method:calcium carbonate oral tablet group (n=27,donors who took one calcium carbonate and vitamin D3 oral tablet 20 min before plateletpheresis),calcium carbonate chewable tablet group (n=25,donors who took one calcium carbonate and vitamin D3 chewable tablet 20 min before plateletpheresis),and non calcium supplementation group (n =24,donors who did not take any calcium supplementation before plateletpheresis).Platelets of donors were collected by MCS + type blood cell separator.And venous blood of 5 mL volume was collected respectively at the different time points of plateletpheresis as follows:before plateletpheresis (about 20 min before plateletpheresis),at the beginning of plateletpheresis,in the process of plateletpheresis (about 30 min at plateletpheresis) and at the end of plateletpheresis.The serum Ca2+ and PTH levels were measured by O-cresolphthalein complexone method and chemiluminescence method,respectively.After plateletpheresis,questionnaires were conducted on donors in calcium carbonate oral tablet group and calcium carbonate chewable tablet group to investigate the satisfaction degree of calcium carbonate tablets.The serum Ca2+ and PTH levels of donors in these 3 groups at different time points,and satisfaction rates of calcium carbonate in calcium carbonate oral tablet group and calcium carbonate chewable tablet group were compared respectively by statistical methods.There were no statistical differences among 3 groups in general data (P＞0.05).Results ① There were no significant differences in serum Ca2+ levels among 3 groups before plateletpheresis and at the beginning of plateletpheresis (P＞ 0.05).In the process of plateletpheresis,serum Ca2+ levels of donors in calcium carbonate oral tablet group,calcium carbonate chewable tablet group and non calcium supplementation group were (2.26±0.06) mmol/L,(2.28±0.04) mmol/L and (2.24±0.06) mmol/L,respectively.There were statistical differences in serum Ca2+ levels among 3 groups (F=3.47,P=0.04).There was no statistical difference in serum Ca2+ levels between calcium carbonate oral tablet group and calcium carbonate chewable tablet group (P =0.08),as well as between calcium carbonate oral tablet group and non calcium supplementation group (P=0.36).But there was statistical difference in serum Ca2+ levels between calcium carbonate chewable tablet group and non calcium supplementation group (P =0.01).At the end of plateletpheresis,serum Ca2+ levels of donors in calcium carbonate oral tablet group,calcium carbonate chewable tablet group and non calcium supplementation group were (2.25-±-0.06) mmol/L,(2.26 ± 0.04) mmol/L and (2.17-±-0.05) mmol/L,respectively.There was statistical difference in serum Ca2+ levels among 3 groups (F=21.29,P＜0.01).There was no statistical difference in serum Ca2+ levels between calcium carbonate oral tablet group and calcium carbonate chewable tablet group (P=0.56).But there was statistical difference in serum Ca2+ levels between calcium carbonate oral tablet group and non calcium supplementation group (P＜0.01),as well as between calcium carbonate chewable tablet group and non calcium supplementation group (P＜0.01).② There were no significant differences in serum PTH levels among 3 groups before plateletpheresis and at the beginning of plateletpheresis (P＞0.05).In the process of plateletpheresis,serum PTH levels of donors in calcium carbonate oral tablet group,calcium carbonate chewable tablet group and non calcium supplementation group were (110 ± 21) pg/L,(102 ± 26) pg/L and (161 ± 40) pg/L,respectively.There was no statistical difference in serum PTH levels between calcium carbonate oral tablet group and calcium carbonate chewable tablet group (P=0.32).But there was statistical difference in serum PTH levels between calcium carbonate oral tablet group and non calcium supplementation group (P＜0.01),as well as between calcium carbonate chewable tablet group and non calcium supplementation group (P＜0.01).At the end of plateletpheresis,serum PTH levels of donors in calcium carbonate oral tablet group,calcium carbonate chewable tablet group and non calcium supplementation group were (95±23) pg/L,(91-±-25) pg/L and (147±-38) pg/L,respectively.There was no statistical difference in serum PTH levels between calcium carbonate oral tablet group and calcium carbonate chewable tablet group (P =0.09).But there was statistical difference in serum PTH levels between calcium carbonate oral tablet group and non calcium supplementation group (P＜0.01),as well as between calcium carbonate chewable tablet group and non calcium supplementation group (P ＜ 0.01).③ A total of 52 questionnaires were distributed in this study,and all of them were completed and recovered.The satisfaction rate of calcium carbonate chewable tablet group was 92.0％ (23/25),which was higher than that of calcium carbonate oral tablet group (59.3 ％,16/27),and the difference was statistically significant (x2 =7.42,P＜0.01).Conclusions Addition of calcium carbonate chewable tablet 20 min before plateletpheresis can make a positive impact on stabilizing serum Ca2+ and PTH levels of male regular plateletpheresis donors.Calcium carbonate chewable tablet could be used before plateletpheresis because of its good taste and easy to take.