献血相关血管迷走神经反应献血者血浆ET-1、NO检测和分析

Plasma ET-1 and NO Levels in Blood Donors with Vasovagal Reaction

目的通过分析献血者血浆内皮素-1(ET-1)和一氧化氮(NO)在发生血管迷走神经性反应时的水平,探讨献血相关血管迷走神经反应(DRVR)可能的发生机制。方法选取2021年1月~2022年5月在三峡大学固定献血屋发生献血相关血管迷走神经性献血反应的献血者83例作为DRVR组,匹配77例正常献血者作为对照组,采用双抗体/抗原夹心ELISA法检测献血者血浆ET-1、NO水平,并将两组进行独立样本t检验分析。结果DRVR组和对照组血浆ET-1含量分别为:24.3(17.9~34.0)pg/mL、20.0(17.9~24.7)pg/mL,差异具有统计学意义(u=2400,P<0.05);DRVR组和对照组血浆NO含量分别为:23.8(21.4~28.7)pg/mL、25.9(23.3~31.9)pg/mL,差异具有统计学意义(u=2395,P<0.05);ET-1/NO值:DRVR组0.85(0.68~1.1)、对照组0.79(0.57~0.94),差异具有统计学意义(u=2454,P<0.05)。结论献血应激导致血浆ET-1的水平上升,NO水平降低,ET-1/NO上调,这种状态在发生血管迷走神经反应的献血者中更加明显,说明其对献血应激的心理压力更大,献血相关血管迷走神经性反应的发生可能主要与献血者对压力调节的心理因素有关。

Objective To investigate the mechanism of donation related vasovagal reaction(DRVR)by analyzing the plasma levels of endothelin-1(ET-1)and nitric oxide(NO)in blood donors with DRVR.Methods From January 2021 to May 2022,83 blood donors with DRVR at China Three Gorges University were enrolled in the DRVR group,and 77 blood donors with no adverse reaction were enrolled in the control group.The plasma ET-1 and NO levels of blood donors were detected by antibody/antigen sandwich ELISA.The data were analyzed by independent sample t test.Results The plasma levels of ET-1in the DRVR and control groups were 24.3(17.9~34.0)pg/mL,and 20.0(17.9~24.7)pg/m(u=2400,P<0.05),while the plasma NO contents were 23.8(21.4~28.7)pg/mL,and 25.9(23.3~31.9)pg/mL(u=2395,P<0.05).The ET-1/NO values of the two groups were 0.85(0.68~1.1)and 0.79(0.57~0.94)(u=2454,P<0.05).Conclusion Blood donation stress increases plasma ET-1 level,decreases NO level,and increases ET-1/NO ratio,a phenomenon more evident in blood donors with vasovagal reaction,who have greater psychological pressure resulting from blood donation.The occurrence of donation related vasovagal reaction may be mainly related to the psychological factors regulating blood donors’stress.