献血前征询体检对献血者主动退出及梅毒和HIV检出的干预效果

Detection of Syphilis and HIV Positive Blood Samples through Blood Screening System

目的了解建立和完善献血前征询体检机制,对高危献血人群主动退出情况,及献血者血液梅毒螺旋体(TP)和艾滋病病毒(HIV)检测的干预效果,从血液采集源头选择低危献血者,保证血液安全。方法选择干预前(2011-2013年)和干预后(2014-2015年3月)浙江省江山市无偿献血者,分团体献血者、个人献血者和互助献血者3组,收集主动退出献血、保密性弃血和献血前梅毒筛查情况资料进行分组比较和统计学分析。结果共计调查19960名无偿献血者,干预前在献血前主动退出献血及保密性弃血者35人,干预后为35人,两组比较差异有统计学意义(χ2=20.72,P<0.01)。2014-2015年3月献血前筛查检出抗-TP阳性35人。干预前检测14 743人,抗-TP阳性率为0.92%(136/14 743),抗-HIV初筛阳性率为0.08%(12/14 743),确诊阳性1例;干预后检测5217人,抗-TP阳性率为0.25%(13/5217),抗-HIV初筛阳性率为0.09%(5/5217),无确诊阳性者;两组抗-TP阳性率比较差异有统计学意义(χ2=23.58,P<0.01),两组抗-HIV初筛阳性率比较差异无统计学意义(χ2=0.09,P>0.05)。干预后团体献血者不合格率与干预前比较差异均有统计学意义(χ2=7.32,P<0.01),互助献血者和个人献血者分别与干预前比较差异均无统计学意义(χ2=1.40、1.64,P>0.05)。结论建立和完善科学合理的献血前征询机制,对献血者主动退出、梅毒阳性检出率及HIV感染确诊率有一定的干预效果。

Objective To evaluate the importance of establishing a reliable blood screening system,to avoid transfusion-transmissible infections with HIV and syphilis,and to ensure the safety of the blood supply.MethodsDonators were divided into non-intervention group（2011-2013）and intervention group（2014-March 2015）after the blood screening system setup,and classified as 3kinds（group,individual and mutual aid）.Information of donators was collected and analyzed related to those who withdrew actively before the donation,the confidentiality of the blood discarding and pre-donation tests of syphilis.Results 19 960 unpaid donators received TP and HIV detection from 2011 to March 2015.The non-intervention group,had 35 cases who withdrew actively from the donation and kept confidentiality of the blood discarding.The intervention group had 35 cases too.Difference between the two groups（χ2=20.72,P 0.01）was statistically significant.The non-intervention group had 14 743 donators screened,with 136（0.92%）cases infected with TP.The intervention group had 5 217 tested donators,with only13（0.25%）cases of TP positive.The difference between the proportions of blood donators with TP positive was statistical significance（χ2=23.58,P0.01）.The non-intervention group had 12donators（0.08%）screened with HIV positive,and the intervention group 5donators（0.09%）,the difference was of no statistical significance（χ2=0.09,P0.05）.Difference of unqualified rate of group donators between the two groups was statistically significant（χ2= 7.32,P0.01）,and difference of mutual aid and individual donators between the two groups was not statistically significant（χ2= 1.40,1.64,P0.05）.Conclusion The establishment of an effective blood screening system is key to ensure the safety of the blood supply and minimize the risk of HIV/syphilis transmission.