摘要
目的探讨成都市无偿献血者丙氨酸转氨酶(ALT)不合格的影响因素。方法采用随机抽样法,选择2012年6月1日至2013年6月1日,于成都市血液中心某街头采血点参加无偿献血的16 424例献血者为研究对象。其中,男性献血者为8 860例,女性为7 564例;年龄为18~55岁。采用干化学法和速率法,分别对献血者血液进行ALT初筛和实验室复检。以献血者血液ALT值>40 U/L,判定为血液初筛或实验室复检ALT不合格。采用唐山启奥5.0信息管理系统收集献血者的性别、年龄、身高、体重、婚姻状况、民族、职业、文化程度和献血季节等资料,并且分别计算不同人口学特征(性别、年龄、婚姻状况、民族、职业、文化程度),献血季节及人体质量指数(BMI)献血者的ALT不合格率。不同人口学特征、献血季节和BMI献血者的ALT不合格率比较,采用χ2检验。采用多因素非条件logistic回归分析,进一步研究无偿献血者ALT不合格的独立影响因素。本研究遵循的程序符合2013年修订的《世界医学协会赫尔辛基宣言》要求,并于献血前与所有献血者签署《献血者知情同意书》。结果①本研究16 424例无偿献血者中,ALT不合格率为14.4%(2 363/16 424)。其中,血液初筛ALT不合格的献血者为2 256例,占95.5%(2 256/2 363);实验室复检ALT不合格者为107例,占4.5%(107/2 363)。②本研究16 424例无偿献血者ALT不合格影响因素的单因素分析结果显示,不同性别、年龄、婚姻状况、职业、文化程度、献血季节和BMI献血者的ALT不合格率分别比较,差异均有统计学意义(χ2=872.65、627.76、575.94、641.88、150.64、50.71、2 152.05,P<0.001)。③多因素非条件logistic回归分析结果显示,男性(OR=3.52,95%CI:3.13~3.96,P<0.001);年龄为26~35岁(OR=1.25,95%CI:1.07~1.46,P<0.001);18.5 kg/m2≤BMI<25.0 kg/m2(OR=2.34,95%CI:1.24~4.45,P=0.010),25.0 kg/m2≤BMI<28.0 kg/m2(OR=7.51,95%CI:3.98~14.29,P<0.001)和BMI≥28.0 kg/m2(OR=19.48,95%CI:10.13~37.45,P<0.001);已婚(OR=1.27,95%CI:1.09~1.47,P<0.001);夏季献血(OR=1.50,95%CI:1.26~1.79,P<0.001),秋季献血(OR=1.79,95%CI:1.51~2.13,P<0.001),冬季献血(OR=1.23,95%CI:1.02~1.47,P<0.001)为献血者ALT不合格的独立危险因素。学生人群为献血者ALT不合格的独立保护因素(OR=0.31,95%CI:0.25~0.37,P<0.001)。结论成都市献血者ALT不合格率处于较高水平。献血者ALT不合格的独立危险因素包括年龄为26~35岁,BMI≥18.5 kg/m2,已婚,以及于夏、秋、冬季参加献血。采供血机构应针对这些独立危险因素,采取相应的措施,降低成都市无偿献血者的ALT不合格率。
Objective To explore the influence factors of unqualified alanine aminotransferase (ALT) of voluntary blood donors in Chengdu. Methods From June 1, 2012 to June 1, 2013, a total of 16 424 voluntary blood donors from a street blood collection point of Chengdu Blood Center were selected as subjects by random sampling method. Among them, there were 8 860 male and 7 564 female donors, aged from 18 to 55 years. Blood samples for ALT primary screening were detected by dry chemical method, and blood samples for ALT laboratory re-examination were detected by rate method. The ALT value > 40 U/L was determined to be unqualified for ALT blood screening or laboratory re-examination of blood donors. The information management system of Tangshan Qiao 5.0 was used to collect the data of blood donors including gender, age, height, weight, marital status, nationality, occupation, educational level and the seasons of blood donation. The ALT unqualified rates of blood donors with different demographic characteristics (gender, age, marital status, nationality, occupation and education level), seasons of blood donation and body mass index (BMI) were calculated respectively. Chi-square test was used to compare the ALT unqualified rates of blood donors with different demographic characteristics, seasons of blood donation and BMI. Multivariate unconditional logistic regression analysis was used to further study the independent influence factors of ALT disqualification in voluntary blood donors. The procedures followed in this study were in accordance with the requirements of the World Medical Association Declaration of Helsinki revised in 2013. And the Informed Consent of Blood Donors were signed with all blood donors before blood donation. Results ① Among the 16 424 voluntary donors in this study, and the unqualified rate of ALT was 14.4%(2 363/16 424). Among them, a number of 2 256 donors failed in ALT primary screening, accounting for 95.5%(2 256/2 363);and 107 donors failed in ALT laboratory re-examination, accounting for 4.5%(107/2 363).② The results of univariate analysis for the influence factors of ALT disqualification in 16 424 voluntary blood donors in this study showed that there were significant differences in ALT unqualified rates among donors of different gender, age, marital status, occupation, education level, seasons of blood donation and BMI, respectively (χ2=872.65, 627.76, 575.94, 641.88, 150.64, 50.71, 2 152.05;P<0.001).③ The results of multivariate unconditional logistic regression analysis showed that male (OR=3.52, 95%CI: 3.13-3.96, P<0.001), age of 26-35 years (OR=1.25, 95%CI: 1.07-1.46, P<0.001), 18.5 kg/m2 ≤ BMI<25.0 kg/m2 (OR=2.34, 95%CI: 1.24-4.45, P=0.010), 25.0 kg/m2≤BMI<28.0 kg/m2 (OR=7.51, 95%CI: 3.98-14.29, P<0.001) and BMI≥28.0 kg/m2 (OR=19.48, 95%CI: 10.13-37.45, P<0.001);married (OR=1.27, 95%CI: 1.09-1.47, P<0.001);blood donation in summer (OR=1.50, 95%CI: 1.26-1.79, P<0.001), blood donation in autumn (OR=1.79, 95%CI: 1.51-2.13, P<0.001), blood donation in winter (OR=1.27, 95%CI: 1.02-1.47, P<0.001) were the independent risk factors for ALT disqualification in blood donors. Student donor was the independent protective factor for ALT disqualification of blood donors (OR=0.31, 95%CI: 0.25-0.37, P<0.001). Conclusions The ALT unqualified rate of blood donors in Chengdu is at a high level. Independent risk factors for ALT disqualification in blood donors included age of 26-35 years, BMI≥18.5 kg/m2, married, and blood donation in summer, autumn and winter. In view of these independent risk factors, corresponding measures should be taken to reduce the ALT unqualified rate of voluntary blood donors in Chengdu.
作者
席光湘
周敏
张蓝江
钟利
刘双丽
何毅
Xi Guangxiang;Zhou Min;Zhang Lanjiang;Zhong Li;Liu Shuangli;He Yi(Chengdu Blood Center, Chengdu 610041, Sichuan Province, China)
出处
《国际输血及血液学杂志》
CAS
2019年第5期413-419,共7页
International Journal of Blood Transfusion and Hematology
关键词
献血者
丙氨酸转氨酶
人群结构
影响因素
不合格率
Blood donors
Alanine transaminase
Population structure
Influence factors
Unqualified rate
