摘要
目的使用纵向研究的设计和分析技术,探讨全血重复献血者间隔期的影响因素。方法本研究采用线性混合效应模型(linear mixed effect model,LMEM)对广州血液中心40 876名在2017年间第二次献全血的献血者截止2019年12月30日的献全血行为进行了跟踪,以经Cox-Box变换后的献血者间隔天数为结局变量,测量其每次献全血时相关的影响因素的变化并建模分析。结果随着献血间隔期序列号的增加,献血者平均献血间隔期呈现缩短趋势,每增加一个献血间隔期,减少-0.002 6个Cox-Box变换后的献血者间隔天数单位(T=-11.47,P<0.000 1),且献血间隔期序列号与其他变量存在广泛的交互效应(P值均<0.05)。在控制了其他变量后,与18—25岁组相比,25—35岁组、35—45岁组及>45岁组献血者献血间隔期均所有延长(参数估计值均为正值,P值均<0.000 1)。考虑年龄组与献血间隔期序列号的交互作用后,其变化方向发生改变,各年龄组与参考年龄组对比,随着献血间隔期序列号的增加,献血间隔期呈现下降趋势(参数估计值均为负值,P值均<0.05)。个人自愿组与团体自愿组对比,其献血间隔期呈现增加趋势(T=3.68,P<0.05)。汉族组与其他民族组对比,其献血间隔期呈现增加趋势(T=3.85,P<0.05),但加入献血间隔期序号的交互作用后,变化反向改变(T=-2.41,P<0.05)。献血400 mL献血者,与较低献血量献血者对比,献血间隔期减少-0.000 7个Cox-Box变换后的献血者间隔天数单位(T=-3.61,P<0.05),考虑了其他因素的交互作用后(个人自愿×400 mL;献血间隔期序号×献血400 mL),变化方向没有改变,减少速率有所变化,其中以个人自愿×400 mL组减少速率最大(参数估计值为-0.002 09)。但献血次数多的献血者,个人自愿者组献血间隔期更短(T=-2.83,P<0.05)。结论随着献血次数的增加,平均献血间隔呈缩短趋势。应做好低年龄组、其他民族组的关爱工作,促进他们保持以较短间隔期重复献血;做好转化团体自愿献血者为个人自愿献血者的相关工作,可能有利于缩短献血者间隔期。
Objective To explore the influencing factors on whole blood donation interval of repeat blood donors using longitudinal study method. Methods In this study, the whole blood donation behavior of 40 876 blood donors who donated whole blood in 2017 for the second time at Guangzhou Blood Center was tracked until December 30, 2019, and analyzed using linear mixed effect model(LMEM). With donation interval after Cox-Box transformation as the outcome variable, the influencing factors related to each donation were measured and then modeled.Results With the increase of donation interval serial number(1—6), the average donation interval got shorter, for every increase in the serial number led to a decrease in interval lenghts after Cox-box transformation by-0.002 6 units(T=-11.47, P<0.000 1). There existed extensive interaction effects between serial numbers and other variables.(P<0.05). The blood donation intervals of donors in 25—35, 35—45, and >45 years old group were all longer than those in 18—25 years group as covariates without statistical differences in LMEM model were excluded(with all parameter estimates positive, P<0.000 1). Considering the trend changed after the interaction between the age group and serial number of blood donation interval, the donation interval in each group showed a downward trend with the increment of serial numbers when compared with the reference age group(with all parameter estimates negative,P<0.05). Blood donation interval of individual voluntary group showed an increasing trend as compared with the group voluntary group(T=3.68, P<0.05).Blood donation interval of the Han nationality showed an increasing trend compared with other nationality groups(T=3.85,P<0.05), but the trend reversed after the interaction with serial number was considered(T=-2.41,P<0.05). The blood donation interval of donors who donated 400 mL blood reduced by-0.000 7 units after Cox-Box transformation, when compared with the interval of those donated lower than 400 mL(T=-3.61, P<0.05). Given the interaction of other factors(such as personal choice and the serial number), differences didn′t notable by the trend direction, but by the lower rate, with personal choice exhibiting the highest lower rate(parameter estimate:-0.002 09). However, the individual volunteer group showed a shorter blood donation interval as the number of donation increased,(T=-2.83, P<0.05). Conclusion The averagely shorter donation intervals could be observed with the increase of donation numbers. Repeat donation with shorter intervals could be expected if high quality service was given to lower-age or minority population. Otherwise, converting group blood donors to individual donors may also helps shorten the donation interval.
作者
郑晓晓
黎世杰
冯凡凡
洪晓春
柯蓉蓉
许颖莹
谢桂芸
谭咏恩
陈锦艳
ZHENG Xiaoxiao;LI Shijie;Feng Fanfan;HONG Xiaochun;KE Rongrong;XU Yingying;XIE Guiyun;TAN Yongen;CHEN Jinyan(Guangzhou Blood Center,The Key Blood Safety Laboratory of Guangzhou,Guangzhou 510080,China)
出处
《中国输血杂志》
CAS
2020年第9期959-964,共6页
Chinese Journal of Blood Transfusion
基金
广州市医学重点学科建设项目(血液安全重点实验室)
广东省医学科学技术研究基金项目(A2019204)
2019年中国输血协会威高科研基金(CSBT-WG-201906)
广州市科技局基础与一般应用基础项目(202002030447)。
关键词
重复献血者
献血间隔期
影响因素
线性混合效应模型
Cox-Box变换
repeat blood donors
blood donation interval
influencing factors
linear mixed effect model(LMEM)
Cox-Box transformation
