CAJ | 학술논문

目的探讨柠檬酸盐抗凝剂对不同性别和不同种族人电解质代谢的影响,为临床检测干预提供参考.方法应用自身交叉、安慰剂对照研究模式,对22名年龄匹配的中国人(男女各11名)和10名白人男性志愿者以标准化的干预方案分别给予柠檬酸盐抗凝剂[1.5 mg/(kg·min)]和相同体积生理盐水(安慰剂)的输注(洗脱间隔期为2～3周);同时采集干预过程中的系列血样和尿样进行血、尿相关指标的检测.结果 22名中国男女试验对象间的基础清蛋白[男(43.05±1.81)g/L,女(42.26±2.67)g/L]和游离钙离子浓度[男(1.27±0.04)mmol/L,女(1.26±0.04)mmol/L]相近;柠檬酸盐的输入可导致中国女性较中国男性有更大的离子钙浓度降幅[女-28.68%(-20.00%～-35.2%),男-23.84%(-16.53%～-29.32%),t=3.19,P＜0.01],但其对血磷[男-18.81%(-3.16%～-25.09%),女-19.23%(-1.22%～-32.16%)]及清蛋白[男-0.32%(3.27%～-7.印%),女1.88%(6.03%～-9.31%)]的代谢影响性别间差异无统计学意义(t值分别为0.36,0.47,P均＞0.05);柠檬酸盐干预可同时导致中国人尿钙排泄增加[干预前0.34(0.09～0.87),干预后0.96(0.18～1.47),t=6.66,P＜0.01].与白人男性相比,中国男性具有较高的离子钙基础水平[中国男性(1.27±0.04)mmol/L,白人男性(1.22±0.02)mmol/L,t=3.7,P＜0.01]和较大幅度的清蛋白生理节律性波动[中国男性-11.72%(-5.70%～-14.21%),白人男性-1.74%(2.43%～-7.68%),t=7.43,P＜0.01].但两种族男性在柠檬酸盐致血离子钙[中国男性-23.84%(-16.53%～-29.32%),白人男性-21.95%(-18.31%～-30.92%)]、磷[中国男性-19.23%(4.65%～-32.16%),白人男性-12.68%(0.68%～-42.19%)]、清蛋白[中国男性-0.32%(1.05%～-7.60%),白人男性-1.39%(1.87%～-7.26%)]和尿钙排泄[中国男性237.70%(11.8%～935%),白人男性234.37%(5.45%～504.00%)]的代谢变化差异无统计学意义(t值分别为0.32、0.03、0.25和0.04,P均＞0.05).2种干预模式下试验对象的镁离子浓度均未见变化.结论柠檬酸盐抗凝剂对机体镁、磷离子及清蛋白的代谢影响不存在着种族和性别间的差异.但其对钙离子代谢影响的性别差异性预示着在机采过程中女性比男性有更高的低钙血症副反应发生的可能. 目的探討檸檬痠鹽抗凝劑對不同性彆和不同種族人電解質代謝的影響,為臨床檢測榦預提供參攷.方法應用自身交扠、安慰劑對照研究模式,對22名年齡匹配的中國人(男女各11名)和10名白人男性誌願者以標準化的榦預方案分彆給予檸檬痠鹽抗凝劑[1.5 mg/(kg·min)]和相同體積生理鹽水(安慰劑)的輸註(洗脫間隔期為2～3週);同時採集榦預過程中的繫列血樣和尿樣進行血、尿相關指標的檢測.結果 22名中國男女試驗對象間的基礎清蛋白[男(43.05±1.81)g/L,女(42.26±2.67)g/L]和遊離鈣離子濃度[男(1.27±0.04)mmol/L,女(1.26±0.04)mmol/L]相近;檸檬痠鹽的輸入可導緻中國女性較中國男性有更大的離子鈣濃度降幅[女-28.68%(-20.00%～-35.2%),男-23.84%(-16.53%～-29.32%),t=3.19,P＜0.01],但其對血燐[男-18.81%(-3.16%～-25.09%),女-19.23%(-1.22%～-32.16%)]及清蛋白[男-0.32%(3.27%～-7.印%),女1.88%(6.03%～-9.31%)]的代謝影響性彆間差異無統計學意義(t值分彆為0.36,0.47,P均＞0.05);檸檬痠鹽榦預可同時導緻中國人尿鈣排洩增加[榦預前0.34(0.09～0.87),榦預後0.96(0.18～1.47),t=6.66,P＜0.01].與白人男性相比,中國男性具有較高的離子鈣基礎水平[中國男性(1.27±0.04)mmol/L,白人男性(1.22±0.02)mmol/L,t=3.7,P＜0.01]和較大幅度的清蛋白生理節律性波動[中國男性-11.72%(-5.70%～-14.21%),白人男性-1.74%(2.43%～-7.68%),t=7.43,P＜0.01].但兩種族男性在檸檬痠鹽緻血離子鈣[中國男性-23.84%(-16.53%～-29.32%),白人男性-21.95%(-18.31%～-30.92%)]、燐[中國男性-19.23%(4.65%～-32.16%),白人男性-12.68%(0.68%～-42.19%)]、清蛋白[中國男性-0.32%(1.05%～-7.60%),白人男性-1.39%(1.87%～-7.26%)]和尿鈣排洩[中國男性237.70%(11.8%～935%),白人男性234.37%(5.45%～504.00%)]的代謝變化差異無統計學意義(t值分彆為0.32、0.03、0.25和0.04,P均＞0.05).2種榦預模式下試驗對象的鎂離子濃度均未見變化.結論檸檬痠鹽抗凝劑對機體鎂、燐離子及清蛋白的代謝影響不存在著種族和性彆間的差異.但其對鈣離子代謝影響的性彆差異性預示著在機採過程中女性比男性有更高的低鈣血癥副反應髮生的可能.
목적 탐토저몽산염항응제대불동성별화불동충족인전해질대사적영향,위림상검측간예제공삼고.방법 응용자신교차、안위제대조연구모식,대22명년령필배적중국인(남녀각11명)화10명백인남성지원자이표준화적간예방안분별급여저몽산염항응제[1.5 mg/(kg·min)]화상동체적생리염수(안위제)적수주(세탈간격기위2～3주);동시채집간예과정중적계렬혈양화뇨양진행혈、뇨상관지표적검측.결과 22명중국남녀시험대상간적기출청단백[남(43.05±1.81)g/L,녀(42.26±2.67)g/L]화유리개리자농도[남(1.27±0.04)mmol/L,녀(1.26±0.04)mmol/L]상근;저몽산염적수입가도치중국녀성교중국남성유경대적리자개농도강폭[녀-28.68%(-20.00%～-35.2%),남-23.84%(-16.53%～-29.32%),t=3.19,P＜0.01],단기대혈린[남-18.81%(-3.16%～-25.09%),녀-19.23%(-1.22%～-32.16%)]급청단백[남-0.32%(3.27%～-7.인%),녀1.88%(6.03%～-9.31%)]적대사영향성별간차이무통계학의의(t치분별위0.36,0.47,P균＞0.05);저몽산염간예가동시도치중국인뇨개배설증가[간예전0.34(0.09～0.87),간예후0.96(0.18～1.47),t=6.66,P＜0.01].여백인남성상비,중국남성구유교고적리자개기출수평[중국남성(1.27±0.04)mmol/L,백인남성(1.22±0.02)mmol/L,t=3.7,P＜0.01]화교대폭도적청단백생리절률성파동[중국남성-11.72%(-5.70%～-14.21%),백인남성-1.74%(2.43%～-7.68%),t=7.43,P＜0.01].단량충족남성재저몽산염치혈리자개[중국남성-23.84%(-16.53%～-29.32%),백인남성-21.95%(-18.31%～-30.92%)]、린[중국남성-19.23%(4.65%～-32.16%),백인남성-12.68%(0.68%～-42.19%)]、청단백[중국남성-0.32%(1.05%～-7.60%),백인남성-1.39%(1.87%～-7.26%)]화뇨개배설[중국남성237.70%(11.8%～935%),백인남성234.37%(5.45%～504.00%)]적대사변화차이무통계학의의(t치분별위0.32、0.03、0.25화0.04,P균＞0.05).2충간예모식하시험대상적미리자농도균미견변화.결론 저몽산염항응제대궤체미、린리자급청단백적대사영향불존재착충족화성별간적차이.단기대개리자대사영향적성별차이성예시착재궤채과정중녀성비남성유경고적저개혈증부반응발생적가능.
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.