献血前丙氨酸氨基转移酶初检策略研究

Preliminary detection of alanine aminotransferase before blood donation

目的探讨献血前丙氨酸氨基转移酶(ALT)筛查的最佳策略,以减少血液资源浪费。方法回顾性分析2020年1~4月重庆某血站无偿献血者血液报废情况,比较接近限值的500名献血者干化学法ALT检测结果与速率法的相关性,及ALT干化学法初检不同水平样本复检不合格率。结果本研究纳入的献血者中,ALT不合格率(0.89%,43/4846)明显高于HBV(0.25%,12/4846)、HCV(0.43%,21/4846)及HIV(0.19%,9/4846)3项(P<0.05),献血前ALT检测接近限值水平的标本(40 U/L≤ALT≤50 U/L),干化学法与速率法ALT检测结果存在弱相关性,相关系数(r)为0.33(P<0.05),ALT干化学法初检45 U/L≤ALT≤50 U/L组,复检不合格率(10.7%,22/206)明显高于ALT<45 U/L组(P<0.05)。结论设定献血前ALT初检预筛限值为45 U/L,对于ALT初检在(45~50)U/L范围内的献血者,抽血样进行ALT速率法检测合格后通知献血。

Objective To explore the optimized strategy of alanine aminotransferase(ALT)screening before blood donation,in order to reduce the waste of blood resources.Methods The blood donation scrapping of one blood center in Chongqing from January to April 2020 was analyzed retrospectively.The correlation between ALT test results by dry chemistry method and rate method in 500 blood donors,with ALT level close to the limit,was analyzed,and the abnormal rates of retest were stratified by initial results of ALT dry chemical method.Results Among blood donors enrolled in this study,the rate of ALT abnormality(0.89%,43/4846)was significantly higher than that of HBV(0.25%,12/4846),HCV(0.43%,21/4846)and HIV(0.19%,9/4846)(P<0.05).For the samples with pre-donation ALT close to the limit(40 U/L≤ALT≤50 U/L),a weak correlation between the results of dry chemistry method and rate method was observed,with correlation coefficient at 0.33(P<0.05).The abnormal rates in retest were significantly higher in 45 U/L≤ALT≤50 U/L(10.7%,22/206)group than that in the ALT<45 U/L group(P<0.05).Conclusion The ALT limit before blood donation should be set to 45 U/L.For blood donors with ALT within the range of(45~50)U/L,blood donation should be deferred until they passed retests by rate method.