无偿献血者血液筛查策略探讨

To Explore the Screening Algorithm for Non-remunerate Voluntary Blood Donations

目的评估不同血液筛查模式对筛查效果的影响,为适应新版《血站技术操作规程》,制订适合本地区的献血者血液筛查策略提供依据。方法选择2010～2011年上海市奉贤区血站37 136例无偿献血标本,其中预约献血标本13 693例,预约后采血标本10 389例,无预约采血标本13 054例。同时在无预约采血者中选择了2 705例在采血前先行ALT快速法,合格后再采血,分析不同的采血模式对筛查不合格率的影响。结果无论是预约还是无预约献血,ALT为主要不合格原因。预约后献血者所有检测指标不合格率(2.70%)明显较无预约者低(5.62%),采血前筛查ALT能有效降低ALT不合格率(从6.33%降为2.88%),而预约后采血能显著降低HBsAg和抗-HCV等其他指标的不合格率(从1.85%降为0.73%)。结论对于计划性的团体无偿献血者的血液筛查,以预约献血结合采血前ALT干化学法筛查的策略为佳。

Objective To assess the effect of different blood screening algorithms on the screening results, to stipu- late for a proper blood screening policy under the guidance of the new version of Blood Bank Technique Regulations of Chi- na. Methods Blood screening results of 37 136 nobn-remunerate voluntary blood donations from Shanghai Fengxian Blood Bank in 2010 to 2011 were selected, among which 13 693 were pre-donated blood samples from appointment blood donors, 10 398 were donation samples from appointment blood donors, and 13 054 were donation samples from un-appointment blood donors. 2 705 donation samples from un-appointment donors with ALT pre-screened were also been selected. The blood screening results were analyzed to enclose the effect of different screening algorithms. ReSults Abnormal ALT were the main unqualified reasons both in appointment and in un-appointment blood donations. The unqualified rate of appoint- ment donations （2. 70%） was significant lower than that of un-appointment donations （5.62%）. ALT screening before blood donation could significantly decrease the unqualified rate （from 6.33%to 2.88%）. And the Unqualified rate of HB- sAg or anti-HCV also could be significantly decreased in appointment donations （0. 73%） when compared to un-appoint- ment donations （1.85%）. Conclusion For the non-remunerate voluntary blood donor, the best screening policy would be appointment donation, which had qualified HBsAg, anti-HCV and other viral markers in appointment testing, and ALT screening before donation.