不同无偿献血人群血液初筛异常情况的分析

The analysis of abnormality screened in free blood donation

目的分析南昌市无偿献血人群初筛不合格情况并提出对策，探讨避免血液资源浪费的有效方法。方法采用回顾性分析方法，统计2015年5月1日至2016年5月31日学生与非学生人群、初次献血与重复献血人群以及全血与成分献血人群血液初筛总不合格率和丙氨酸转氨酶（ALT）、乙型肝炎表面抗原（HBsAg）及血红蛋白（Hb）不合格率。结果学生人群总不合格率较非学生人群明显升高（3．6％比2．6％），其中学生人群HBsAg不合格率明显高于非学生人群（2．5％比2．0％），ALT不合格率明显低于非学生人群（0．04％比1．50％），差异均有统计学意义（P均〈0．01）；但是学生人群与非学生人群Hb不合格率比较差异无统计学意义（0．08％比0．10％，P〉0．05）。初次献血者总不合格率（2．6％比1．4％）和HBsAg不合格率（3．4％比0．04％）明显高于重复献血者，ALT不合格率明显低于重复献血者（0．91％比1．09％，P均〈0．05）。成分献血者总不合格率（1．19％比3．50％）和HBsAg不合格率（0．28％比2．54％）明显低于全血献血者（P均〈0．01）；而成分献血与全血献血者ALT不合格率比较差异无统计学意义（O．71％比0．86％，P〉0．05）。结论对于不同献血人群，制定合适的筛查模式，可有效提高输血安全。重复献血者在进行团体献血时，可考虑取消HBsAg金标法，学生团体献血时，可考虑取消ALT的初筛检测。

Objective To review the unqualified causes preliminary screening of unpaid blood donors in Nanchang, and put forward countermeasures to avoid the waste of blood resources. Methods From May 1, 2015 to May 31, 2016, the total unqualified rate of total and component preliminary screening among the whole blood donors and the platelet donors, student and non-student groups, and primary and repeat blood donors were retrospeeively analysed . The unqualified rate of alanine aminotransferase （ALT） , Hepatitis b surface antigen （HBsAg） and hemoglobin （Hb） were retrospecivcly analysed. Results The total unqualified rates （3.6% vs. 2.6%） of the student are higher than the non-student, the unqualified rate of HBsAg （2.5% vs. 2.0%） among the student group was higher than that of the non-student group, and the unqualified rate of ALT from the student group was significantly lower than that of the non-student group （0.04% vs. 1.50%, P all〈 0.01）. There was no significant difference in the failure rate of Hb between students and non-students （0.08% vs. 0.10%, P 〉 0.05）. There were significant differences in the total failure rate （2.6% vs. 1.4%） and HBsAg positive rate （3.4% vs. 0.04%） between the first and the repeat blood donors, and the rate of ALT failure was lower than that of repeat donors （0.91% vs. 1.09%, P all 〈 0.05）. There were significant differences in total failure rate （1.19% vs. 3.50%） and HBsAg positive rate （0.28% vs. 2.54%） between the whole blood donors and the platelet donors （P all〈 0.01）, but no significant difference in ALT failure ratess （0.71% vs. 0.86%, P 〉 0.05）. Conclusions To formulate a suitable pattern is an effective way to improve the safety of blood transfusion for different types of blood donors. We may consider abolishing the HBsAg gold standard method test screened in the repeat blood donors, and abolishing the ALT screening test of student groups.