成都市无偿献血者脂肪血的人群分布及其影响因素分析

Analysis of population distribution of voluntary blood donors with lipemia and its influencing factors in Chengdu

目的探讨成都市无偿献血者中脂肪血的人群分布情况及其影响因素。方法选择2013年3月1日至2014年3月1日于成都市血液中心某采血组献血的13 726人次献血者为研究对象。采用比浊图片法判断献血者脂肪血的发生情况。采用单因素分析和非条件多因素logistic回归分析法研究不同人口统计学特征[性别、年龄、文化程度、婚姻状况、职业、人体质量指数（BMI）]、献血季节、献血次数对脂肪血发生的影响。结果本组13 726人次献血者所捐献血液中，脂肪血为990人次，脂肪血发生率为7.2%（990/13 726）。其中，重度乳糜的脂肪血为351人次，占2.6%（351/13 726），中度乳糜的脂肪血为639人次，占4.7%（639/12 727）。男性献血者脂肪血发生率为9.3%（632/6 799），高于女性的5.2%（358/6 927），并且差异有统计学意义（χ2＝20.85，P〈0.05）；已婚献血者脂肪血发生率为10.4%（551/5 290），高于单身者的5.2%（439/8 436），并且差异亦有统计学意义（χ2＝127.17，P〈0.05）。不同年龄段、文化程度、职业、BMI、献血季节、献血次数的献血者脂肪血发生率比较，差别均有统计学意义（χ2＝24.37、61.91、23.53、101.39、10.41、11.52，P〈0.05）。非条件多因素logistic回归分析结果显示，性别（OR＝1.71，95%CI：1.48～1.91, P〈0.05），年龄（OR＝1.20，95%CI：1.09～1.33，P〈0.05），职业（OR＝0.96，95%CI：0.94～0.98，P〈0.05），BMI（OR＝1.71，95%CI：1.53～1.90，P〈0.05）及献血季节（OR＝0.91，95%CI：0.86～0.98，P〈0.05）是献血者发生脂肪血的独立危险因素。结论成都市献血者脂肪血的分布具有明显倾向性，主要集中在男性、肥胖、35岁以上的献血人群，应针对这部分献血人群采取相应措施，最大程度的避免不合格血液采集，有效降低脂肪血的发生率，减少血液资源的浪费。

Objective To explore the population distribution and influencing factors of voluntary blood donors with lipemia in Chengdu. Methods From March 1st, 2013 to March 1st, 2014, a total of 13 726 voluntary blood donors in the Chengdu Blood Center were recruited in the study. Turbidimetric method was used to determine the occurrence of lipemia. Univariate analysis and unconditional multivariate logistic regression analysis were used to analyze the impact of demographic characteristics, including gender, age, education level, marital status, occupation and bod mass index （BMI）; season of blood donation, and frequency of blood donation on the occurrence of lipemia. Results Among 13 726 voluntary blood donors, the incidence rate of lipemia was 7.2% （990/13 726）. Among them, the incidence of severe celiac blood fat was 2.6% （351/13 726）, and incidence of moderate celiac blood fat was 4.7% （639/13 726）. The incidence of lipemia in male donors was significantly higher than that in female donors （9.30% vs 5.2%, 2 =20.85, P〈0.05）, and it was also significantly higher in married donors than that in unmarried donors （10.4% vs 5.2%, 2 =127.17, P〈O. 05）. Differences in the incidence rate of lipemia in different age, education level, occupation, BMI, season of blood donation, and frequency of blood donation were also statisticallysignificant （X2=24.37, 61.91, 23.53, 101.39, 10.41, 11.52; P〈0.05）. The unconditional multivariate logistic regression analysis results showed that gender （OR= 1.71, 95%CI： 1.48-1.91, P〈0.05）, age （OR=1.20, 95%CI： 1.09-1.33, P〈0. 05）, occupation （OR=0.96, 95%CI： 0.94-0. 98, P〈20.05）, BMI （0R=1.71, 95%CI： 1. 53-1. 90, P〈0.05）, and season of blood donation （OR=0. 91, 95%CI： 0.86-0. 98, P〈0. 05）, were independent risk factors of lipemia. Conclusions There is a clear tendentiousness in distribution of donors with lipemia in chengdu, mainly in donors who were male, obesity, and over the age of 35. Appropriate measures should be taken to avoid blood collection in this donors, reduce the incidence of lipemia and waste of blood resources.