Haddad Salim, Leitman Susan F, Wesley Robert A, Cecco Stacey, Yau Yu Ying, Starling Judith, Rehak Nadja N, Bolan Charles D
Department of Transfusion Medicine, Warren Grant Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland, USA.
Transfusion. 2005 Jun;45(6):934-44. doi: 10.1111/j.1537-2995.2005.04312.x.
Marked decreases in ionized magnesium (iMg) levels occur during large-volume leukapheresis (LVL); however, the effect of intravenous (IV) magnesium supplementation in this setting has not been carefully studied.
Thirty healthy allogeneic peripheral blood progenitor cell donors receiving citrate anticoagulant with IV calcium prophylaxis were randomized to receive either IV magnesium (0.2 mg Mg per mL acid citrate dextrose-A) or placebo during LVL, with a double-blind design.
Thirty subjects underwent 75 LVL pro- cedures, 37 with magnesium and 38 with placebo. Group characteristics were similar for sex, weight, citrate infusion rate (1.36 mg/kg/min vs. 1.37 mg/kg/min), and volume processed (16 L vs. 17 L). Serum iMg levels remained within the reference range with magnesium supplementation, but decreased 39+/-11 percent below baseline (p<10(-10)) after placebo, with greater decreases after consecutive procedures. Subjects receiving magnesium had more vigorous parathyroid hormone responses and higher glucose levels and also tended to have higher serum potassium and ionized calcium levels. Mild paresthesias, coldness, and nausea occurred in 28, 20, and 7 percent of donors, respectively, with no significant differences between groups. Severe symptoms (chest tightness) occurred in only one subject receiving placebo.
IV magnesium supplementation exerts a significant impact on serum magnesium levels, but does not reduce the frequency or severity of the relatively mild citrate-related effects observed in LVL performed with continuous IV calcium prophylaxis.
在大容量白细胞单采术（LVL）期间，离子镁（iMg）水平会显著下降；然而，在这种情况下静脉补充镁的效果尚未得到仔细研究。
30名接受枸橼酸盐抗凝并预防性静脉补钙的健康异基因外周血祖细胞供者，采用双盲设计，随机分为在LVL期间接受静脉镁（每毫升酸性枸橼酸葡萄糖 - A中含0.2毫克镁）或安慰剂组。
30名受试者接受了75次LVL操作，其中37次使用镁，38次使用安慰剂。两组在性别、体重、枸橼酸盐输注速率（1.36毫克/千克/分钟对1.37毫克/千克/分钟）和处理血量（16升对17升）方面的特征相似。补充镁后血清iMg水平保持在参考范围内，但安慰剂组在操作后血清iMg水平比基线下降了39±11%（p<10⁻¹⁰），连续操作后下降幅度更大。接受镁的受试者甲状旁腺激素反应更强烈，血糖水平更高，血清钾和离子钙水平也往往更高。分别有28%、20%和7%的供者出现轻度感觉异常、发冷和恶心，两组之间无显著差异。仅一名接受安慰剂的受试者出现严重症状（胸闷）。
静脉补充镁对血清镁水平有显著影响，但并不能降低在持续静脉补钙预防的LVL中观察到的相对较轻的枸橼酸盐相关效应的频率或严重程度。
