广州市无偿献血人群血液检测不合格情况回顾及多因素Logistics回归分析

Retrospection and multivariate Logistic regression analysis of unqualified blood testing among voluntary blood donors in Guangzhou

目的回顾近年来本地区无偿献血人群血液检测不合格情况,分析影响血液检测结果的各类因素,为制定更合理的招募策略,提高血液安全性,避免血液资源浪费提供依据。方法选取2016~2020年广州地区1548204例无偿献血者作为研究对象,采用2遍ELISA 1遍NAT的检测策略对血液标本进行筛查,统计不同年份以及不同人群的不合格情况并用多因素Logistics回归分析各人群血液检测不合格的风险。结果2016~2020年广州地区无偿献血者检测总体不合格率为2.52%(39378/1548204),呈先下降后上升趋势(P<0.05),HBsAg和ALT是主要的不合格项,不合格率分别为0.65%(10129/1548204)和1.22%(18824/1548204);男性献血者不合格率为3.10%(31091/1004079),高于女性(P<0.05),18~25岁献血者不合格率为1.84%(12781/694374),低于其他3个年龄段献血者(P<0.05),学生献血者不合格率1.33%(4024/302007)低于其他职业(P<0.05),本科学历献血者不合格率1.57%(5379/341662)低于其他学历(P<0.05),团体志愿献血者不合格率2.62%(21307/813664)高于个人志愿献血者(P<0.05),初次献血者不合格率4.57%(24469/535551)高于重复献血者(P<0.05),全血献血者不合格率2.84%(38111/1340678)高于单采成分血献血者(P<0.05);性别、年龄、职业、学历、是否重复献血以及献血成分均是影响血液检测结果的危险因素。结论2016~2020年广州市无偿献血人群血液检测不合格率呈总体上升趋势,HBsAg和ALT是主要不合格项,且在人口学以及献血特征等方面存在差异,宜根据不同人群检测不合格率的分布特征以及风险,优化招募策略,加强低风险人群的宣传,增强献血前的咨询和筛查,减少血液报废,保证血液安全性。

Objective To retrospectively analyze the unqualified blood screening results of voluntary blood donors in Guangzhou area during 2016~2020, and analyze various factors that affect the blood screening results, for the purpose of providing a scientific basis for recruitment and retention of blood donors, improving blood safety, and avoiding waste of blood resources. Methods A total of 1 548 204 voluntary blood donors in Guangzhou from 2016 to 2020 were selected as the research objects, and the blood samples were screened by dual ELISA and once NAT. The unqualified rate of different years and populations were counted and the analysis of risks of unqualified blood testing was performed by conditional Logistics regression. Results An overall unqualified rate of blood screening was 2.52% in Guangzhou from 2016 to 2020, the unqualified rate of every year showed a downward trend first and then an upward trend. HBsAg and ALT were the two primary deferral causes, the positive rate was 0.65%(10 129/1 548 204) and 1.22%(18 824/1 548 204), respectively;the unqualified rate in male blood donors3.10%(31 091/1 004 079) was significantly higher than that in female(P<0.05), and that in blood donors aged 18~25 was 1.84%(12 781/694 374), which was lower than the other three age groups(P<0.05). Fewer students(1.33%,4 024/302 007) and bachelor degree donors(1.57%,5 379/341 662) were deferred. Compared with individual blood donors, group blood donors’ deferral rate(2.62%,21 307/813 664) was higher. The deferral rate of first-time blood donors(4.57%, 24 469/535 551) were higher than the repeated blood donors(P<0.05), meanwhile, whole blood donors(2.84%, 38 111/1 340 678) higher than those apheresis donors(P<0.05). Gender, age, occupation, education, frequency and blood components donated were risk factors for unqualified blood screening. Conclusion The deferral rates of voluntary blood donors in Guangzhou showed an overall upward trend, from 2016 to 2022. HBsAg and ALT were the primary deferral causes, and there were differences in demographics and blood donation characteristics. To formulate targeted recruitment strategies according to the test results of voluntary blood donors, and strengthen the publicity of low-risk groups and the consultation and screening before blood donation, will be a great benefit for reducing the blood scrap and guaranteeing the blood safety.