高原地区献血对血管性血友病因子的影响及其临床价值探讨

Effect of blood donation in high altitude area on von willebrand factor and its clinical value exploration

目的探讨高原地区献血对血管性血友病因子（vWF）的影响及其临床价值。方法收集了西藏昌都地区自愿献血的血液标本82例,其中多次献血标本42例（献血组）,分为低频、中频、高频3个献血亚组,其中低频献血为2次,20例;中频献血为3次~9次,13例;高频献血为≥10次,9例。初次献血前体检合格样本40例（对照组）。用ELISA方法检测献血组和对照组的vWF与人脂蛋白相关磷脂酶A2（Lp-PLA2）的水平,并记录2组相应的血常规和血脂等指标。结果多次献血后vWF浓度明显低于对照组,差异有统计学意义（P〈0.05）,而献血组Lp PLA2浓度和对照组比较差异无统计学意义（P〉0.05）;对高原地区献血影响因素的Logistic回归分析表明,vWF下降为多次献血后机体的保护因素;在低频、中频、高频献血亚组的K-M概率分析中,随着献血频次的增加,非血管内皮损伤的概率逐渐升高,差异有统计学意义（χ~2=40.092,P〈0.01）。结论 vWF与高原地区多次献血的关系密切,vWF下降是多次献血后机体的保护因素。随着献血次数增多,机体潜在的不良血管内皮状态可能会得到一定的修正或改善。

Objective To explore the effect of blood donation in high altitude area on von willebrand factor（ v WF） and its clinical value. Methods 82 blood samples were collected from the voluntary blood donations in Changdu area of Tibet. 42 cases were from multiple blood donations,and divided into low frequency,medium frequency,high frequency subgroups; there were2 blood donations in low frequency subgroup（ 20 cases）,3- 9 blood donations in medium frequency subgroup（ 13 cases）,and10 and more blood donations in high frequency subgroup（ 9 cases）. 40 cases with qualified physical examination before initial blood donation were collected as control group. Using ELISA method to detect the v WF and human lipoprotein associated phospholipase A2（ Lp- PLA2） levels of donation group and control group,and recording the two groups corresponding indicators of blood routine and blood lipid. Results v WF concentration of donation group was significantly lower than the control group,with the difference statistically significant（ P〈0. 05）. However,the difference on the concentration of Lp- PLA2 in two groups had no statistical significance（ P〉0. 05）. Logistic regression analysis of influencing factor of high altitude area blood donation showed that v WF decline was the protective factor of the body after multiple blood donations. In the K- M probability analysis of the low frequency,intermediate frequency and high frequency blood donors,with the increase of the frequency of blood donation,the probability of non- vascular endothelial injury increased gradually,and there was statistical significance on the difference（ χ2= 40. 092,P 〈0. 01）. Conclusion v WF is closely related to the multiple blood donation in the high altitude area,and the decrease of v WF is the protection factor of the body. With the increase of blood donation,the potential adverse vascular endothelial status of the body can be modified or improved.