无偿献血者血液筛查不合格原因分析

Analysis on the Causes of Unqualified Blood Screening Result in Voluntary Blood Donors

目的分析广州市无偿献血者血液筛查结果,了解血液不合格的主要原因,为保障血液供应与安全提供参考。方法对2011-2017年捐献的2 201 646例无偿献血标本进行血液筛查,项目包括ALT、HBs Ag、抗-HCV、抗-HIV、抗-TP以及HBV/HCV/HIV核酸扩增检测(NAT),对不合格结果及变化趋势进行统计分析。结果 2011-2017年广州地区无偿献血血液筛查总不合格率为3.37%,ALT、HBs Ag、抗-HCV、抗-HIV、抗-TP和NAT不合率分别为1.37%、0.87%、0.37%、0.12%、0.43%和0.22%。ALT和HBs Ag不合格分别占不合格总数的33.22%和19.12%。2011-2017年血液筛查总不合格率经Joinpoit趋势分析,年度变化率差异有统计学意义(APC=13.12,P<0.05)。结论2011-2017年广州市无偿献血血液筛查不合格率呈下降趋势(P<0.05);ALT和HBs Ag为不合格的主要项目,应当对各项目不合格的原因,尤其是ALT筛查的必要性及标准进一步深入研究。

Objective To analyze the donated blood screening results in Guangzhou from 2011 to 2017 for reducing the discard of blood as useless. Methods From 2011 to 2017,blood screening were performed in 2 201 646 samples,test items including Glutamic-pyruvic transaminase（ ALT）,Hepatitis B surface antigen（ HBs Ag）,Hepatitis C virus antibody（ antiHCV）,Human immunodeficiency syndrome virus antibody（ anti-HIV）,Treponema pallidum antibody（ anti-TP） and HBV/HCV/HIV nucleic acid amplification test（ NAT）. Result The total unqualified rate of donated blood screening in Guangzhou was 3. 37 % in 2011-2017,the unqualified rate of ALT,HBs Ag,anti-HCV,anti-HIV,anti-TP and NAT were 1. 37 %,0.87 %,0. 37 %,0. 12 %,0. 43 % and 0. 22 %,respectively. The disqualification of ALT and HBs Ag accounted for 33. 22 percent and 19. 12 percent of the total disqualification,respectively. The total unqualified rate of blood screening in Guangzhou from 2011 to 2017 was analyzed by Joinpoint trend,and the annual percent change（ APC） was significantly different（ P〈0. 05）. Conclusion The total unqualified rate of blood screening in Guangzhou from 2011 to 2017 showed a downward trend（ P〈0. 05）; ALT and HBs Ag were the major causes of disqualification,The further study of screening items should be performed,especially the necessity and standard of ALT screening.