高频率单采血小板捐献者骨代谢标志物变化及骨密度分析*

doi:10.3969/j.issn.1671-2587.2026.02.011

临床输血与检验 ›› 2026, Vol. 28 ›› Issue (2): 221-226.DOI: 10.3969/j.issn.1671-2587.2026.02.011

高频率单采血小板捐献者骨代谢标志物变化及骨密度分析^*

严仲文¹, 林栋¹, 陈宝婵², 叶群弟¹, 曹芷茗¹, 陈丽妮¹, 聂成利¹, 付昕³, 张伟龙³, 黄志森¹

¹东莞市中心血站,广东东莞 523000;
²东莞东华医院,广东东莞 523000;
³广东医科大学附属东莞第一医院,广东东莞 523000

收稿日期:2025-06-05 接受日期:2025-08-19 出版日期:2026-04-20 发布日期:2026-04-22
作者简介:严仲文,主要从事临床输血研究,（E-mail）477836070@qq.com。
基金资助:
^*本课题受广东省东莞市社会发展科技重点项目（No.20221800906142）资助

Changes in Bone Metabolism Markers and Bone Mineral Density in High-frequency Apheresis Platelet Donors

YAN Zhongwen¹, LIN Dong¹, CHEN Baochan², YE Qundi¹, CAO Zhiming1, CHEN Lini¹, NIE Chengli¹, FU Xin³, ZHANG Weilong³, HUANG Zhisen¹

¹Dongguan Central Blood Station, Dongguan 523000;
²Dongguan Tungwah Hospital, Dongguan 523000;
³The First Dongguan Affiliated Hospital of Guangdong Medical University, Dongguan 523000

Received:2025-06-05 Accepted:2025-08-19 Online:2026-04-20 Published:2026-04-22

摘要/Abstract

摘要： 目的分析高频率单采血小板对捐献者骨代谢标志物变化及骨密度（BMD）的影响。方法（1）招募2年捐献30次单采血小板21人,分别在项目开始的第1次、第10次、第20次及第30次献血时留取标本,留取时间点包括献血前（血小板采集前,未口服葡萄糖酸钙）、献血中（程序开始采集时立即服用含葡萄糖酸钙1.2 g的葡萄糖酸钙锌口服溶液20 mL,采集至30 min时留取标本）、献血后1 h（采集结束后1 h）和献血后24 h（采集结束后24 h）。（2）招募近两年每年捐献单采血小板≥10次且单采总次数70次以上和未献过单采血小板的全血捐献者各50人,在常态下献血前（献血小板间隔14天以上,献全血间隔6个月以上,未口服葡萄糖酸钙）留取标本检测项目基础值。上述2项的标本检测项目为血Ca、全段甲状旁腺素（iPTH）、骨钙素（OST,OC）、Ⅰ型胶原蛋白分解物羧基端片段（CTX-Ⅰ,β-胶原特殊序列）和25-羟基维生素D[25-(OH)D]。计算OST/CTX-Ⅰ的比值,以评估骨转换的优势取向。（3）招募近两年每年捐献单采血小板≥10次且单采总次数80次以上者26人测量BMD,与未献过单采血小板的24名在医院正常体检者的BMD进行对比。BMD检测方法为双能X线吸收法（DXA）,检测部位为腰椎和髋关节。结果（1）2年30次单采血小板捐献者Ca在不同献血时间点和献血次数之间比较都有显著性差异,iPTH、OST、CTX-Ⅰ、OST/CTX-Ⅰ、25-(OH)D不同献血时间点之间比较有显著性差异,P<0.05;Ca和iPTH呈负相关,iPTH和OST、OST和CTX-Ⅰ呈正相关,P<0.05。（2）近两年每年捐献单采血小板≥10次且单采总次数70次以上捐献者常态下血Ca基础值低于未献单采血小板的全血捐献者,而OST、CTX-Ⅰ则高于后者,P<0.05。（3）近两年每年捐献单采血小板≥10次且单采总次数80次以上捐献者整体腰椎BMD低于未献过单采血小板的正常体检者,P<0.05;两组整体髋关节BMD比较无统计学差异,P>0.05。结论骨代谢标志物在献血不同时间点和献血次数之间出现统计学差异,献血中以骨形成为优势;总次数70次以上高频率血小板捐献者常态下血钙基线水平下降和骨代谢率提高;总次数80次以上高频率捐献血小板对腰椎BMD产生影响。随着捐献总次数和频率的增加,对捐献者的相关提示与健康宣教也应加强,同时加强监测（如骨代谢标志物、BMD检测等）以更好地保护献血者安全。

关键词: 单采血小板, 血钙, 骨代谢, 骨密度, 枸橼酸盐, 甲状旁腺素

Abstract: Objective To explore the effects of high-frequency plateletpheresis on bone metabolism markers and bone mineral density (BMD) in donors. Methods (1) Twenty-one donors were enrolled and completed 30 plateletpheresis procedures within a 2-year timeframe. Specimens were collected at the 1 st, 10th, 20th, and 30th donations, with sampling time points including pre-donation, during donation, 1 hour post-donation, and 24 hours post-donation. (2) Fifty donors with ≥10 plateletpheresis sessions and over 70 cumulative apheresis procedures, together with 50 whole blood donors in the past two years, were recruited. Specimens were collected prior to donation to detect baseline levels of calcium (Ca), intact parathyroid hormone (iPTH), osteocalcin (OST/OC), C-terminal telopeptide of type I collagen (CTX-Ⅰ, β-crosslaps), and 25-hydroxyvitamin D [25-(OH)D]. The OST/CTX-Ⅰ ratio was calculated to evaluate the dominant direction of bone turnover. (3) Twenty-six donors with ≥10 plateletpheresis sessions and more than 80 cumulative apheresis procedures, as well as 24 healthy physical examination participants, underwent BMD measurement. BMD was assessed by dual-energy X-ray absorptiometry (DXA) at the lumbar spine and hip joints. Results (1) Significant differences in Ca levels in 30 plateletpheresis donors were noted among different donation frequencies and sampling time points. The levels of iPTH, OST, CTX-Ⅰ, OST/CTX-Ⅰ ratio, and 25-(OH)D differed significantly across various sampling time points (P<0.05). A negative correlation was found between Ca and iPTH, while positive correlations existed between iPTH and OST, and between OST and CTX-Ⅰ (all P<0.05). (2) Donors with over 70 cumulative apheresis procedures (≥10 times annually) had lower baseline serum Ca levels and higher OST and CTX-Ⅰ levels compared with blood donors (P<0.05). (3) Donors with over 80 cumulative apheresis procedures (≥10 times annually) showed lower lumbar spine BMD than the healthy non-donors (P<0.05), whereas no statistically significant difference in hip BMD was detected between the two groups (P>0.05). Conclusion High-frequency plateletpheresis can alter bone metabolism and BMD, accelerate bone metabolism, and render bone formation the dominant process during donation. As the total number and frequency of donations rise, it is essential to strengthen targeted guidance and health education for donors, and intensify monitoring (e.g., detection of bone metabolism markers, BMD) to better protect donor safety.

Key words: Plateletpheresis, Serum calcium, Bone metabolism, Bone mineral density, Citrate, Parathyroid hormone

中图分类号:

R331.1

严仲文, 林栋, 陈宝婵, 叶群弟, 曹芷茗, 陈丽妮, 聂成利, 付昕, 张伟龙, 黄志森. 高频率单采血小板捐献者骨代谢标志物变化及骨密度分析^*[J]. 临床输血与检验, 2026, 28(2): 221-226.

YAN Zhongwen, LIN Dong, CHEN Baochan, YE Qundi, CAO Zhiming1, CHEN Lini, NIE Chengli, FU Xin, ZHANG Weilong, HUANG Zhisen. Changes in Bone Metabolism Markers and Bone Mineral Density in High-frequency Apheresis Platelet Donors[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2026, 28(2): 221-226.

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高频率单采血小板捐献者骨代谢标志物变化及骨密度分析^*

Changes in Bone Metabolism Markers and Bone Mineral Density in High-frequency Apheresis Platelet Donors

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