输血前患者感染性指标检测结果分析

Test results of infectious indices from patients before blood transfusion

目的 对输血前患者感染性指标检测结果进行回顾性分析,探讨输血前检查的重要意义。方法 选择河北医科大学第三医院2011～2013年41 925例预输血患者,采用酶联免疫吸附试验进行HBsAg、抗-HCV、抗-HIV和抗-TP检测。结果 1）2011～2013年预输血患者HBsAg、抗-HCV、抗-HIV和抗-TP阳性率分别为13.48%、2.42%、0.055%和3.98%,总感染率为19.9%（8 358/41 925）。抗-HIV和抗-TP阳性率有逐年上升趋势（P〈0.05）,抗-HCV阳性率有逐年下降的趋势;2）男性HBsAg、抗-HIV和抗-TP阳性率高于女性（P〈0.05）。HBsAg和抗-TP阳性率有随年龄的增加而增高的趋势（P〈0.05）;3）受检患者中,职员的感染率高于工人、农民等,肿瘤患者的感染率高于血液病、创伤等患者,重症感染的患者的感染率高于大量失血、凝血异常、贫血或低蛋白血症等患者,差异比较均具有统计学意义（P〈0.01）。结论 本院输血前患者抗-HIV和抗-TP阳性率上升趋势明显,输血前感染检查对于了解预输血患者的身体感染状况以及输血感染的责任认定具有重要意义。抗-HCV阳性率下降可能与卫生管理的加强有关。

Objective To analyzetbe test results and trends of four types of infectionsin patients before blood transfusion;to explore the significance of testing before blood transfusion. Methods A total of 41 925 cases of pre-transfusion patients were collected fromThird Hospital of Hebei Medical University in 2011-2013. HBsAg, anti-HCV, anti-HIV and anti-TP were detected by ELISA. Results 1 ） A total of 41 925 patients, the positive rates of HBsAg, anti-HCV, anti-HIV and anti-TP werel3.48% ,2.42% ,0.055% and 3.98% ,respectively, The positive rates of anti-HIV and anti-TP have a rising trend year by year（ P 〈 0. 05 ）. 2） The positive ratesof HBsAg, anti-HIV and anti-TP in males were higher than those of females, demonstrating a statistically significant differenee （P 〈 0. 05 ）. The positive rates of HBsAg and anti-TP positive rate have increased with age （P 〈0. 05 ）. 3） Among the patients who underwent testing,the infection rate was higher in workers and peasants. Among tumor patients, the infection rate was higherin patients who have blood disorders and trauma injuries. Among patients who experience severe＇ infection,their infection rate is attributed to huge loss of blood, clotting abnormalities, anemia or hypoalbuminemia. The differenceswere statistically significant （P 〈 0. 01 ）. Conclusion Thepositive rates of anti-HIV and anti- TP showed an increasing trendamong pre-transfusion patientsin this hospital. Testing for infections before blood transfusion is of great significance for understanding the status of infection of pre-transfusion patientsandaffirming the responsibilitiesin blood transfusions. Declining positive rates of anti-HCV may be associated with the strengthening of health management.