采供血机构中关于献血者ALT检测策略的探讨

Discussion on ALT Testing Strategies of Blood Donors in Blood Collection and Supply Institutions

目的分析昆明地区献血前筛查ALT项目和献血前不筛查ALT项目的血液报废情况,在采血量和报废率之间找到一个平衡点,以达到既能节约时间和成本、提高效率,又能有效控制ALT血液报废率的目的。方法选取昆明地区2016年1月—2018年5月血液采集人群共计307929人次作为研究对象,对无偿献血者献血前经过ALT筛查和未经ALT筛查检测结果ALT不合格率进行分析比较。结果2016年1月—2018年3月ALT报废率在进行献血前ALT检测的情况下平均为0.78%,2018年4—5月在不进行献血前筛查的情况下ALT总的报废率为1.96%,但其中团体献血,特别是高校、部队等ALT报废率仅为0.59%。结论在街头无偿献血现场应用干式生化仪坚持实施献血前ALT筛查,可以显著降低无偿献血的不合格率。如果街头献血前不进行ALT检测,将会浪费大量血液资源,对今后的献血员血液赔付也会造成巨大压力。在团体献血中,特别是高校、部队等献血前可不进行ALT检测,既能有效提高效率,报废率也在可接受范围内。

Objective To find a balance point between blood collection volume and rejection rate by analyzing the ALT items before blood donation screening and non-screening ALT items before blood donation in Kunming area,which can save time and cost and improve efficiency.It can also effectively control the ALT blood rejection rate.Methods A total of 307,929 blood collection populations in Kunming from January 2016 to May 2018 were selected as the research objects,and the unqualified rates of unpaid blood donors who had undergone ALT screening and those who had not been ALT screening before blood donation were analyzed and compared.Results In January 2016 to May 2018,the ALT rejection rate averaged 0.78%under the pre-donation ALT test.From April to May 2018,the total ALT rejection rate was 1.96%without pre-donation screening,but among them,group blood donation,especially the ALT rejection rate of colleges and military units,was only 0.59%.Conclusion The application of dry-type biochemical analyzer to the ALT screening before blood donation in the street free blood donation site can significantly reduce the unqualified rate of free blood donation.If the ALT test is not performed before blood donation on the street,a lot of blood resources will be wasted,and it will also cause great pressure on the blood compensation of blood donors in the future.In group blood donation,ALT testing is not required before blood donation,especially in universities and military units,which can effectively improve efficiency and the scrap rate is also within an acceptable range.