Mercan D, Bastin G, Lambermont M, Dupont E
Department of Immunology and Transfusion, Erasme Hospital, Brussels Free University, Belgium.
Transfusion. 1997 Apr;37(4):418-22. doi: 10.1046/j.1537-2995.1997.37497265343.x.
The infusion of citrate during apheresis may affect the levels of ionized magnesium in the blood. Hypomagnesemia and concomitant hypocalcemia could influence the parathormone response and could be responsible for some of the symptoms observed during apheresis.
The study reports measurement of ionized magnesium by the new ion-selective electrode technique in response to citrate infusion in 15 donors undergoing continuous flow high-yield plateletpheresis. The monitoring included measurement of ionized calcium and parathormone every 30 minutes during the 120-minute apheresis (plus the next 30 minutes to assess recovery).
Ionized magnesium fell by 30 +/- 4 percent (mean +/- SD, p<0.01), which contrasts with minor changes in total concentrations. Comparison of variations in the levels of ionized and total magnesium found major formation of complexes during citrate infusion. Ionized calcium fell by 15 +/- 3 percent (p<0.01), while parathormone peaked at 356 +/- 114 percent (p<0.01) of initial value after 30 minutes. Ionized cations and parathormone recovered by more than 50 percent within 30 minutes of the end of apheresis.
An acute and steep drop in ionized magnesium occurs during citrate administration. The measurement of ionized magnesium should be included in future prospective studies of donor safety and parathormone regulation during apheresis.
在血液成分单采过程中输注柠檬酸盐可能会影响血液中离子化镁的水平。低镁血症及伴随的低钙血症可能会影响甲状旁腺激素反应，并可能是血液成分单采过程中观察到的一些症状的原因。
本研究报告了采用新的离子选择电极技术对15名接受连续流动高产率血小板单采的献血者在输注柠檬酸盐后的离子化镁进行测量。监测包括在120分钟的血液成分单采过程中（加上接下来的30分钟以评估恢复情况）每30分钟测量一次离子化钙和甲状旁腺激素。
离子化镁下降了30±4%（平均值±标准差，p<0.01），这与总浓度的微小变化形成对比。对离子化镁和总镁水平变化的比较发现，在输注柠檬酸盐期间主要形成了复合物。离子化钙下降了15±3%（p<0.01），而甲状旁腺激素在30分钟后达到初始值的356±114%（p<0.01）的峰值。在血液成分单采结束后30分钟内，离子化阳离子和甲状旁腺激素恢复了超过50%。
在输注柠檬酸盐期间，离子化镁会出现急性且急剧的下降。在未来关于血液成分单采过程中献血者安全性和甲状旁腺激素调节的前瞻性研究中，应包括对离子化镁的测量。
