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Article(id=1240375106531283036, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240375105386238038, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202311283, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1699977600000, receivedDateStr=2023-11-15, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773658070451, onlineDateStr=2026-03-16, pubDate=1711296000000, pubDateStr=2024-03-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773658070451, onlineIssueDateStr=2026-03-16, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773658070451, creator=13701087609, updateTime=1773658070451, updator=13701087609, issue=Issue{id=1240375105386238038, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='6', pageStart='961', pageEnd='1152', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773658070179, creator=13701087609, updateTime=1773658539618, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1240377074414833974, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240375105386238038, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1240377074414833975, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240375105386238038, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=1118, endPage=1122, ext={EN=ArticleExt(id=1240375106778746974, articleId=1240375106531283036, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Unqualified situations of blood test of voluntary blood donors, Changsha, 2018-2022, columnId=1228016571713520579, journalTitle=Modern Preventive Medicine, columnName=Health Supervison, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the unqualified situation of blood test of voluntary blood donors in Changsha from 2018 to 2022, and to provide reference for the formulation of recruitment strategy of voluntary blood donors.

Methods

From January 2018 to December 2022, 792 508 voluntary blood donors in Changsha area (Changsha Blood Center) were selected as the subjects of this study. Blood samples were tested by enzyme-linked immunosorbent assay (ELISA) twice and nucleic acid detection (NAT) once. The unqualified blood tests in different years and populations were described.

Results

The total unqualified rate of voluntary blood donors in Changsha from 2018 to 2022 was 1.76%, with the highest rate in 2018 (1.90%) and the lowest rate in 2022 (1.56%). The total failure rate of alanine aminotransferase (ALT) and hepatitis B virus surface antigen (HBsAg) ranked first (1.00%) and second (0.62%), respectively. There were significant differences in the unqualified rate of blood test for HBsAg, anti-HCV, anti-HIV, anti-TP, ALT and the single reactivity rate of nucleic acid test (NAT) among different years (P<0.05), and there were significant differences in the unqualified rate of blood test for volunteer blood donors with different gender, age, education level and occupation (P<0.05).

Conclusion

The total unqualified rate of blood testing of voluntary blood donors in Changsha from 2018 to 2022 has significantly decreased compared with that before 2018 in the same region, and ALT and HBsAg are the main reasons for unqualified blood testing. In order to promote the sustainable and healthy development of voluntary blood donation in Changsha, it is necessary to further improve the blood testing technology, optimize the blood collection and supply process, and then improve the accuracy of the test results.

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目的

分析长沙地区2018—2022年无偿献血者血液检测不合格情况，为无偿献血者招募策略的制定提供参考。

方法

选取2018年1月至2022年12月长沙地区（长沙血液中心）792 508例无偿献血者作为本次研究对象。采用2次酶联免疫吸附试验（ELISA）和1次核酸检测技术（NAT）进行血液检测，描述不同年份、不同特征人群的血液检测不合格情况。

结果

2018—2022年长沙地区无偿献血者血液检测总不合格率为1.76%，其中2018年最高（1.90%），2022年最低（1.56%）。丙氨酸氨基转移酶（ALT）、乙型肝炎病毒表面抗原（HBsAg）的血液检测总不合格率分别居第1位（1.00%）、第2位（0.62%）。不同年份HBsAg、丙型肝炎病毒抗体（抗-HCV）、人类免疫缺陷病毒抗体（抗-HIV）、梅毒螺旋体抗体（抗-TP）、ALT的血液检测不合格率及核酸检测（NAT）单反应性率差异有统计学意义（P<0.05）。不同性别、年龄、文化程度、职业无偿献血者血液检测结果不合格率差异有统计学意义（P<0.05）。

结论

2018—2022年长沙地区无偿献血者血液检测总不合格率较同地区2018年前有明显下降，ALT、HBsAg是造成血液检测不合格的主要原因。为促进长沙地区无偿献血事业可持续健康发展，需要进一步完善血液检测技术，优化采供血流程，进而提高检测结果的准确性。

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谭爱春，E-mail：
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陈再新（1981—），男，硕士，主管技师，研究方向：献血者征询体检初筛及献血不良反应处理

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陈再新（1981—），男，硕士，主管技师，研究方向：献血者征询体检初筛及献血不良反应处理

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陈再新（1981—），男，硕士，主管技师，研究方向：献血者征询体检初筛及献血不良反应处理

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Laboratory Medicine and Clinic, 2020, 17(23): 3466-3468, 3472., articleTitle=Analysis of unqualified blood infectious index of unpaid blood donors in Weinan area, refAbstract=null)], funds=[Fund(id=1240746301646754551, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240375106531283036, awardId=2021JJ70130, language=CN, fundingSource=湖南省自然科学基金项目(2021JJ70130), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1240746298538775139, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240375106531283036, xref=1., ext=[AuthorCompanyExt(id=1240746298547163748, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240375106531283036, companyId=1240746298538775139, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Component Blood Donation Service, Changsha Blood Center, Changsha, Hunan 410001, China), AuthorCompanyExt(id=1240746298551358053, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240375106531283036, companyId=1240746298538775139, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.长沙血液中心成分献血服务部，湖南 长沙 410001)]), AuthorCompany(id=1240746298610078310, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240375106531283036, xref=2., ext=[AuthorCompanyExt(id=1240746298618466919, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240375106531283036, companyId=1240746298610078310, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.南华大学附属长沙中心医院检验科)])], figs=[ArticleFig(id=1240746300510098106, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240375106531283036, language=EN, label=Table 1, caption=

Unqualified blood tests among voluntary blood donors in Changsha from 2018 to 2022 [n (%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
年份总献血人数总不合格人数HBsAg抗-HCV抗-HIV抗-TPALT抗-HTLVNAT单反应性
2018157 0512 989（1.90）1 162（0.74）298（0.19）172（0.11）456（0.29）1 382（0.88）21（0.013）439（0.28）
2019160 1343 006（1.88）1 104（0.69）224（0.14）144（0.09）439（0.27）1 297（0.81）27（0.017）256（0.16）
2020151 7252 665（1.76）895（0.59）152（0.10）159（0.10）365（0.24）1 168（0.77）36（0.023）261（0.17）
2021163 8562 823（1.72）868（0.53）197（0.12）131（0.08）361（0.22）1 851（1.13）39（0.024）147（0.09）
2022159 7422 484（1.56）914（0.57）47（0.03）126（0.08）282（0.18）2 204（1.38）34（0.021）298（0.19）
合计792 50813 967（1.76）4 943（0.62）918（0.12）732（0.09）1 903（0.24）7 902（1.00）157（0.020）1 401（0.18）
χ2值71.36578.348188.74013.53853.927424.1216.659167.997
P值<0.001<0.001<0.0010.009<0.001<0.0010.155<0.001
), ArticleFig(id=1240746300610761407, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240375106531283036, language=CN, label=表1, caption=

2018—2022年长沙地区无偿献血者血液检测不合格情况[n（%）]

, figureFileSmall=null, figureFileBig=null, tableContent=
年份总献血人数总不合格人数HBsAg抗-HCV抗-HIV抗-TPALT抗-HTLVNAT单反应性
2018157 0512 989（1.90）1 162（0.74）298（0.19）172（0.11）456（0.29）1 382（0.88）21（0.013）439（0.28）
2019160 1343 006（1.88）1 104（0.69）224（0.14）144（0.09）439（0.27）1 297（0.81）27（0.017）256（0.16）
2020151 7252 665（1.76）895（0.59）152（0.10）159（0.10）365（0.24）1 168（0.77）36（0.023）261（0.17）
2021163 8562 823（1.72）868（0.53）197（0.12）131（0.08）361（0.22）1 851（1.13）39（0.024）147（0.09）
2022159 7422 484（1.56）914（0.57）47（0.03）126（0.08）282（0.18）2 204（1.38）34（0.021）298（0.19）
合计792 50813 967（1.76）4 943（0.62）918（0.12）732（0.09）1 903（0.24）7 902（1.00）157（0.020）1 401（0.18）
χ2值71.36578.348188.74013.53853.927424.1216.659167.997
P值<0.001<0.001<0.0010.009<0.001<0.0010.155<0.001
), ArticleFig(id=1240746300728201923, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240375106531283036, language=EN, label=Table 2, caption=

Comparison of blood test failures among voluntary blood donors of different genders [n (%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
性别总献血人数总不合格人数HBsAg抗-HCV抗-HIV抗-TPALT抗-HTLVNAT单反应性
男499 2819 598（1.92）3 445（0.69）698（0.14）598（0.12）1 169（0.23）5 940（1.19）68（0.014）1 050（0.21）
女293 2274 369（1.49）1 498（0.51）220（0.08）134（0.05）734（0.25）1 962（0.67）87（0.030）351（0.12）
χ2值199.49195.62966.990109.8422.0194 989.002.684866.983
P值<0.001<0.001<0.001<0.0010.155<0.0010.101<0.001
), ArticleFig(id=1240746300828865226, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240375106531283036, language=CN, label=表2, caption=

不同性别无偿献血者的血液检测不合格情况比较[n（%）]

, figureFileSmall=null, figureFileBig=null, tableContent=
性别总献血人数总不合格人数HBsAg抗-HCV抗-HIV抗-TPALT抗-HTLVNAT单反应性
男499 2819 598（1.92）3 445（0.69）698（0.14）598（0.12）1 169（0.23）5 940（1.19）68（0.014）1 050（0.21）
女293 2274 369（1.49）1 498（0.51）220（0.08）134（0.05）734（0.25）1 962（0.67）87（0.030）351（0.12）
χ2值199.49195.62966.990109.8422.0194 989.002.684866.983
P值<0.001<0.001<0.001<0.0010.155<0.0010.101<0.001
), ArticleFig(id=1240746300946305744, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240375106531283036, language=EN, label=Table 3, caption=

Comparison of blood test failures among voluntary blood donors of different age groups [n (%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
年龄总献血人数总不合格人数HBsAg抗-HCV抗-HIV
18~<30岁372 4784 618（1.24）1 675（0.45）335（0.09）412（0.11）
30~<40岁269 4526 497（2.41）a1 643（0.61）a324（0.12）a276（0.10）
40~<60岁150 5782 852（1.89）ab1 625（1.08）ab259（0.17）ab44（0.03）ab
χ2值1 257.741686.79363.10381.457
P值<0.001<0.001<0.001<0.001
年龄总献血人数抗-TPALT抗-HTLVNAT单反应性
18~<30岁372 478446（0.12）3 315（0.89）81（0.022）148（0.04）
30~<40岁269 452707（0.26）a3 826（1.42）a48（0.018）377（0.14）a
40~<60岁150 578750（0.50）ab761（0.51）ab28（0.019）876（0.58）ab
χ2值649.201900.0931.3591 816.639
P值<0.001<0.0010.507<0.001
), ArticleFig(id=1240746301055357652, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240375106531283036, language=CN, label=表3, caption=

不同年龄阶段无偿献血者的血液检测不合格情况比较[n（%）]

, figureFileSmall=null, figureFileBig=null, tableContent=
年龄总献血人数总不合格人数HBsAg抗-HCV抗-HIV
18~<30岁372 4784 618（1.24）1 675（0.45）335（0.09）412（0.11）
30~<40岁269 4526 497（2.41）a1 643（0.61）a324（0.12）a276（0.10）
40~<60岁150 5782 852（1.89）ab1 625（1.08）ab259（0.17）ab44（0.03）ab
χ2值1 257.741686.79363.10381.457
P值<0.001<0.001<0.001<0.001
年龄总献血人数抗-TPALT抗-HTLVNAT单反应性
18~<30岁372 478446（0.12）3 315（0.89）81（0.022）148（0.04）
30~<40岁269 452707（0.26）a3 826（1.42）a48（0.018）377（0.14）a
40~<60岁150 578750（0.50）ab761（0.51）ab28（0.019）876（0.58）ab
χ2值649.201900.0931.3591 816.639
P值<0.001<0.0010.507<0.001
), ArticleFig(id=1240746301143438046, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240375106531283036, language=EN, label=Table 4, caption=

Comparison of blood test failures among voluntary blood donors from different professions [n (%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
职业总献血人数总不合格人数HBsAg抗-HCV抗-HIV
学生154 593406（0.26）185（0.12）123（0.08）139（0.09）
医务人员26 754176（0.66）a64（0.24）a24（0.09）18（0.07）
教师6 58481（1.23）ab24（0.36）ab7（0.11）4（0.06）
公务员9 632145（1.51）ab43（0.45）ab11（0.11）6（0.06）
工人/农民45 294781（1.72）ab230（0.51）ab22（0.05）17（0.04）a
职员140 1312 450（1.75）ab1 008（0.72）ab158（0.11）108（0.08）
其他409 5209 928（2.40）abcdef3 389（0.83）abc573（0.14）abe440（0.11）bcdef
χ2值3 248.2801 014.51157.57085.008
P值<0.001<0.001<0.001<0.001
职业总献血人数抗-TPALT抗-HTLVNAT单反应性
学生154 593154（0.10）185（0.12）29（0.019）79（0.05）
医务人员26 75421（0.08）112（0.42）a3（0.001）40（0.15）a
教师6 5847（0.11）37（0.56）ab2（0.030）13（0.20）a
公务员9 63212（0.12）69（0.72）ab2（0.021）46（0.48）ab
工人/农民45 294217（0.48）abcd475（0.10）bcd13（0.029）301（0.66）abc
职员140 131294（0.21）abe1 737（1.24）abcde23（0.016）294（0.21）ad
其他409 5201 198（0.29）abcdef5 287（1.29）abcde85（0.021）628（0.15）adef
χ2值327.1941 759.7624.269821.101
P值<0.001<0.0010.640<0.001
), ArticleFig(id=1240746301227324133, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240375106531283036, language=CN, label=表4, caption=

不同职业无偿献血者的血液检测不合格情况比较[n（%）]

, figureFileSmall=null, figureFileBig=null, tableContent=
职业总献血人数总不合格人数HBsAg抗-HCV抗-HIV
学生154 593406（0.26）185（0.12）123（0.08）139（0.09）
医务人员26 754176（0.66）a64（0.24）a24（0.09）18（0.07）
教师6 58481（1.23）ab24（0.36）ab7（0.11）4（0.06）
公务员9 632145（1.51）ab43（0.45）ab11（0.11）6（0.06）
工人/农民45 294781（1.72）ab230（0.51）ab22（0.05）17（0.04）a
职员140 1312 450（1.75）ab1 008（0.72）ab158（0.11）108（0.08）
其他409 5209 928（2.40）abcdef3 389（0.83）abc573（0.14）abe440（0.11）bcdef
χ2值3 248.2801 014.51157.57085.008
P值<0.001<0.001<0.001<0.001
职业总献血人数抗-TPALT抗-HTLVNAT单反应性
学生154 593154（0.10）185（0.12）29（0.019）79（0.05）
医务人员26 75421（0.08）112（0.42）a3（0.001）40（0.15）a
教师6 5847（0.11）37（0.56）ab2（0.030）13（0.20）a
公务员9 63212（0.12）69（0.72）ab2（0.021）46（0.48）ab
工人/农民45 294217（0.48）abcd475（0.10）bcd13（0.029）301（0.66）abc
职员140 131294（0.21）abe1 737（1.24）abcde23（0.016）294（0.21）ad
其他409 5201 198（0.29）abcdef5 287（1.29）abcde85（0.021）628（0.15）adef
χ2值327.1941 759.7624.269821.101
P值<0.001<0.0010.640<0.001
), ArticleFig(id=1240746301323793129, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240375106531283036, language=EN, label=Table 5, caption=

Comparison of blood test failures among voluntary blood donors with different educational levels [n (%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
文化程度总献血人数总不合格人数HBsAg抗-HCV抗-HIV抗-TPALT抗-HTLVNAT单反应性
高中及以下345 6919 916（2.87）2 893（0.84）553（0.16）392（0.11）1 106（0.32）4 183（1.21）98（0.028）829（0.24）
高中以上446 8174 051（0.91）2 050（0.46）365（0.08）340（0.08）797（0.18）3 719（0.83）59（0.013）572（0.13）
χ2值4 332.676449.467121.82329.389163.058281.67422.569138.031
P值<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001
), ArticleFig(id=1240746301441233647, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240375106531283036, language=CN, label=表5, caption=

不同文化程度无偿献血者的血液检测不合格情况比较[n（%）]

, figureFileSmall=null, figureFileBig=null, tableContent=
文化程度总献血人数总不合格人数HBsAg抗-HCV抗-HIV抗-TPALT抗-HTLVNAT单反应性
高中及以下345 6919 916（2.87）2 893（0.84）553（0.16）392（0.11）1 106（0.32）4 183（1.21）98（0.028）829（0.24）
高中以上446 8174 051（0.91）2 050（0.46）365（0.08）340（0.08）797（0.18）3 719（0.83）59（0.013）572（0.13）
χ2值4 332.676449.467121.82329.389163.058281.67422.569138.031
P值<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001
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长沙地区2018—2022年无偿献血者血液检测不合格情况分析
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陈再新 1 , 马小华 2 , 谭爱春 2
现代预防医学 | 卫生监督 2024,51(6): 1118-1122
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现代预防医学 | 卫生监督 2024, 51(6): 1118-1122
长沙地区2018—2022年无偿献血者血液检测不合格情况分析
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陈再新1, 马小华2, 谭爱春2
作者信息
  • 1.长沙血液中心成分献血服务部，湖南 长沙 410001
  • 2.南华大学附属长沙中心医院检验科

    • 陈再新（1981—），男，硕士，主管技师，研究方向：献血者征询体检初筛及献血不良反应处理

通讯作者:

谭爱春，E-mail：
Unqualified situations of blood test of voluntary blood donors, Changsha, 2018-2022
Zai-xin CHEN1, Xiao-hua MA2, Ai-chun TAN2
Affiliations
  • Department of Component Blood Donation Service, Changsha Blood Center, Changsha, Hunan 410001, China
出版时间: 2024-03-25 doi: 10.20043/j.cnki.MPM.202311283
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摘要
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目的

分析长沙地区2018—2022年无偿献血者血液检测不合格情况，为无偿献血者招募策略的制定提供参考。

方法

选取2018年1月至2022年12月长沙地区（长沙血液中心）792 508例无偿献血者作为本次研究对象。采用2次酶联免疫吸附试验（ELISA）和1次核酸检测技术（NAT）进行血液检测，描述不同年份、不同特征人群的血液检测不合格情况。

结果

2018—2022年长沙地区无偿献血者血液检测总不合格率为1.76%，其中2018年最高（1.90%），2022年最低（1.56%）。丙氨酸氨基转移酶（ALT）、乙型肝炎病毒表面抗原（HBsAg）的血液检测总不合格率分别居第1位（1.00%）、第2位（0.62%）。不同年份HBsAg、丙型肝炎病毒抗体（抗-HCV）、人类免疫缺陷病毒抗体（抗-HIV）、梅毒螺旋体抗体（抗-TP）、ALT的血液检测不合格率及核酸检测（NAT）单反应性率差异有统计学意义（P<0.05）。不同性别、年龄、文化程度、职业无偿献血者血液检测结果不合格率差异有统计学意义（P<0.05）。

结论

2018—2022年长沙地区无偿献血者血液检测总不合格率较同地区2018年前有明显下降，ALT、HBsAg是造成血液检测不合格的主要原因。为促进长沙地区无偿献血事业可持续健康发展，需要进一步完善血液检测技术，优化采供血流程，进而提高检测结果的准确性。

长沙地区  /  无偿献血  /  血液检测  /  不合格率  /  分布特征
Objective

To analyze the unqualified situation of blood test of voluntary blood donors in Changsha from 2018 to 2022, and to provide reference for the formulation of recruitment strategy of voluntary blood donors.

Methods

From January 2018 to December 2022, 792 508 voluntary blood donors in Changsha area (Changsha Blood Center) were selected as the subjects of this study. Blood samples were tested by enzyme-linked immunosorbent assay (ELISA) twice and nucleic acid detection (NAT) once. The unqualified blood tests in different years and populations were described.

Results

The total unqualified rate of voluntary blood donors in Changsha from 2018 to 2022 was 1.76%, with the highest rate in 2018 (1.90%) and the lowest rate in 2022 (1.56%). The total failure rate of alanine aminotransferase (ALT) and hepatitis B virus surface antigen (HBsAg) ranked first (1.00%) and second (0.62%), respectively. There were significant differences in the unqualified rate of blood test for HBsAg, anti-HCV, anti-HIV, anti-TP, ALT and the single reactivity rate of nucleic acid test (NAT) among different years (P<0.05), and there were significant differences in the unqualified rate of blood test for volunteer blood donors with different gender, age, education level and occupation (P<0.05).

Conclusion

The total unqualified rate of blood testing of voluntary blood donors in Changsha from 2018 to 2022 has significantly decreased compared with that before 2018 in the same region, and ALT and HBsAg are the main reasons for unqualified blood testing. In order to promote the sustainable and healthy development of voluntary blood donation in Changsha, it is necessary to further improve the blood testing technology, optimize the blood collection and supply process, and then improve the accuracy of the test results.

Changsha area  /  Voluntary blood donation  /  Blood testing  /  Unqualified rate  /  Distribution characteristics
陈再新, 马小华, 谭爱春. 长沙地区2018—2022年无偿献血者血液检测不合格情况分析. 现代预防医学, 2024 , 51 (6) : 1118 -1122 . DOI: 10.20043/j.cnki.MPM.202311283
Zai-xin CHEN, Xiao-hua MA, Ai-chun TAN. Unqualified situations of blood test of voluntary blood donors, Changsha, 2018-2022[J]. Modern Preventive Medicine, 2024 , 51 (6) : 1118 -1122 . DOI: 10.20043/j.cnki.MPM.202311283
正文
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输血作为一种替代性治疗，在挽救危重症患者的生命安全中起着重要的作用。近几十年以来，我国无偿献血事业取得了阶段性的发展。根据国家卫健委发布的数据显示，我国无偿献血人次和采血量呈现持续增长的趋势，其中2022年有超1 600万人次参与无偿献血、较1998年增长了48倍，每千人口献血率由1998年的4.8‰提升到2022年的11.5‰[1-2]。血液检测是保障用血安全的关键环节，可避免因输血而造成患者感染其他疾病[3]。本研究对长沙地区2018—2022年无偿献血者的血液检测结果进行分析，并了解血液检测不合格的人群分布特征，旨在为无偿献血者招募策略的制定提供科学指导。
1 对象与方法
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1.1 研究对象
2018年1月至2022年12月长沙地区（长沙血液中心）792 508例无偿献血者为本次研究对象，男499 281例，女293 227例；年龄18~<60岁，平均（31.42±4.38）岁。无偿献血者均已经通过体格检查和血液初筛，并符合《献血者检查健康要求（GB18467-2012）》中的相关规定。
1.2 方法
1.2.1 实验室检测
参考《血站技术操作规程（2019）版》，采用2次酶联免疫吸附试验（ELISA）和1次核酸检测技术（NAT）对无偿献血者的血液标本进行检测，具体流程如下：2个试剂厂家ELISA四项初试：（1）ELISA显示均为阴性标本：6人为一组进行NAT混检，混检结果显示反应性则进行拆分重新鉴别，拆分结果显示反应性则表示血液检测不合格。（2）其余标本采取ELISA和NAT同时进行检测的模式：①初试2个试剂ELISA显示反应性标本，实验室检测最终结果为反应性，则表明血液检测不合格。②初试单个试剂ELISA显示反应性标本：HBsAg、抗-HCV、抗-TP中任意一项呈反应性，使用相同试剂进行复检，结果显示为反应性则表示血液检测不合格；抗-HIV反应性，使用2种试剂分别进行复检，结果显示为反应性则表示血液检测不合格。试剂盒和仪器的使用方法严格按照说明书执行。
1.2.2 结果判定
HBsAg、抗-HCV、抗-HIV、抗-TP等检测项目中任意一项检测结果或NAT检测结果不合格则表示血液检测不合格，2次ELISA结果显示反应性或者1次ELISA结果显示反应性，复检后仍呈反应性，则表示血液检测不合格，ALT双试剂>50U/L或单试剂及复检>50U/L，则表示血液检测不合格。
1.3 统计学分析
计量资料用（）描述；计数资料用n（%）描述，采用χ2检验比较不同特征献血者血液检测不合格率差异，多重比较采用χ2分割检验，应用χ2趋势检验分析2018—2022年长沙地区无偿献血者血液检测不合格率的变化趋势。双侧检验水准α=0.05，软件为SPSS 23.0。
2 结果
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2.1 无偿献血者血液检测不合格情况
2018—2022年期间长沙地区无偿献血者血液检测总不合格率为1.76%，其中2018年最高（1.90%），2022年最低（1.56%），呈现逐年下降的趋势（χ2=66.500，P<0.001）。ALT、HBsAg的血液检测总不合格率分别居第1位、第2位。不同年份HBsAg、抗-HCV、抗-HIV、抗-TP、ALT的血液检测不合格率及NAT单反应性率差异有统计学意义（P<0.05），不同年份抗-HTLV的血液检测不合格率差异无统计学意义（P>0.05）。见表1。
2.2 不同性别无偿献血者的血液检测不合格情况
男女性无偿献血者的血液检测总不合格率差异有统计学意义（P<0.05）；男性无偿献血者的HBsAg、抗-HCV、抗-HIV、ALT的血液检测不合格率和NAT单反应性率高于女性无偿献血者（P<0.05）。见表2。
2.3 不同年龄阶段无偿献血者血液检测不合格情况
30~<40岁无偿献血者的血液检测总不合格率最高；不同年龄阶段无偿献血者HBsAg、抗-HCV、抗-TP、ALT的血液检测不合格率和NAT单反应性率差异有统计学意义（P<0.05），30~<40岁无偿献血者ALT血液检测不合格率显著高于18~<30岁、40~<60岁无偿献血者（P<0.017），18~<30岁、30~<40岁无偿献血者抗-HIV血液检测不合格率显著高于40~<60岁无偿献血者（P<0.017）。见表3。
2.4 不同职业无偿献血者血液检测检测不合格情况
其他职业、职员的血液检测总不合格率分别居第1位、第2位，学生的血液检测总不合格率排末位。不同职业无偿献血者HBsAg、抗-HCV、抗-HIV、抗-TP、ALT的血液检测总不合格率、NAT单反应率差异有统计学意义（P<0.05）。见表4。
2.5 不同文化程度无偿献血者血液检测检测不合格情况
高中及以下文化程度无偿献血者的血液检测总不合格率和HBsAg、抗-HCV、抗-HIV、抗-TP、ALT、抗-HTLV的血液检测不合格率和NAT单反应性率大于高中以上文化程度无偿献血者（P<0.05）。见表5。
3 讨论
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血液是一种目前无法人工合成的医疗资源，自2015年我国大规模开展对无偿献血者的血液标本核酸检测以来，因输血导致患者感染乙肝、丙肝、HIV等疾病的风险显著降低，为临床用血的安全提供了保障[4]。本研究对2018—2022年长沙地区无偿献血者血液检测不合格情况进行了调查，结果显示，血液检测总不合格率为1.76%，低于郑州地区[5]和重庆市主城区[6]，略高于连云港地区[7]，也明显低于长沙市2009—2015年无偿献血者血液检测不合格率（5.96%）[8]，与长沙地区严格采供血工作规范化的管理及人口素质的提升有关。
本研究发现，ALT血液检测总不合格率位居第一位，不合格人数占比最大（7 902/13 967），与济宁市[9]和广州市[10]的情况相似。原因是：在新冠疫情背景下，献血人群的生活压力和工作压力日益增加（劳累），加上受到不良饮食习惯（如过度饮酒）、生活作息紊乱（如经常熬夜）等非病理因素的影响，导致近2年内血液标本中ALT不合格率出现升高。另外，献血前ALT初筛出现假阴性结果也是影响ALT检测不合格率升高的的重要因素，一方面，在使用干式化学法初筛不合格献血者时容易因操作失误导致检测结果异常；另一方面，采血人员未对干式化学法使用的纸条进行定期质检，容易因纸条失效导致检测结果异常。因此，采血人员应该重视采血前的征询工作，对不符合要求的人员建议暂缓献血；同时夯实血站工作人员的专业技能，规范采血流程，避免操作失误；此外质量控制部门需要定期对仪器、检测试剂等进行质检，进而降低ALT检测不合格率。HBsAg的血液检测总不合格率为0.62%。原因可能是金标法是HBsAg初筛的常用检测方法，结果等待时间短，但是容易因病毒载量过低而导致结果出现假阴性；同时部分采血人员的责任意识不强，操作流程不规范，容易出现漏诊现象，故血液检测总不合格率较高。
本研究中2018—2022年长沙地区抗-HIV的血液检测总不合格率为0.09%，低于2012—2013年该地区的血液检测总不合格率（0.34%）[11]。这得益于检测技术的更新迭代，HIV初筛的准确性显著增加。2020年抗-HIV的血液检测总不合格率升高至0.10%，可能是因为该时期新冠疫情在我国开始大规模流行，长沙地区大学生群体基数大，是新冠疫情下无偿献血的主要对象，在2020年抗-HIV阳性人群中多为艺体类低年级新生，他们较往届学生呆在学校的时间较短，主要以校外线上学习为主，这类人群的自制能力差，多原因叠加效应可导致抗-HIV的血液检测总不合格率升高。既往国内外相关报道显示，校外青年由于缺少社会网络的支持和社会资源，其感染HIV的风险高于校内青年[12-13]，可见需要进一步加强对校外线上学习低年级学生的防艾知识宣传教育力度，提高该类人群对HIV的认知，增强自我保护意识。
本研究中抗-HTLV的血液检测总不合格率为0.020%，比成都地区献血人群血清中抗-HTLV阳性率（0.060%）[14]、东南沿海省份献血人群中抗-HTLV阳性率（0.027%）低[15]。说明长沙属于HTLV低流行区域，但是本研究的献血者均为健康人，已经将潜在HTLV征询不合格者予以剔除，同时仅对献血者血浆袋中的标本进行了HTLV检测，未采集血细胞及血清进行送检，可能会出现漏诊者，所以长沙地区的抗-HTLV实际阳性率可能高于本研究数据。本研究ELISA（-）/NAT（+）的血液标本中NAT单反应性率为0.18%，低于广州市的0.20%[16]，高于温州地区的0.12%[17]。NAT技术已被广泛应用于血液筛检中，其特异性和灵敏度较高，可缩短病毒感染检测窗口期，促使输血残余风险显著降低。
在各人群血液检测不合格率的分布情况中，男性总体不合格率明显高于女性，体现在HBsAg、抗-HCV、抗-HCV、ALT等项目，与玉溪市[18]和北京地区[19]的情况大致相同。HBsAg、抗-HCV的性别差异也符合我国的流行特征[20]。男性ALT的血液检测不合格率显著高于女性，可能是因为男性的生活压力大，加上经常熬夜和酗酒，可导致肝脏代谢功能下降，引起偶发性ALT升高。30~<40岁无偿献血者的血液检测总不合格率最高（2.41%），18~<30岁无偿献血者的血液检测总不合格率最低（1.24%），可能是因为本研究调查的地区有多所高校，大学生献血人群占主体，他们的身体素质较好，文化素养高，其血液质量相对比较安全。因此，在无偿献血者的招募过程中需要重点关注男性献血者的征询工作，加大献血知识的宣教力度，倡导青年人群和年轻女性积极参与无偿献血，有利于提高血液安全性[18]。
本研究发现，不同文化程度无偿献血者中高中及以下者血液检测总不合格率更高，这与既往金云霞[21]和李敏[22]结果一致。可能是因为文化程度越低的献血者接受健康教育活动的次数越少，卫生医药保健知识普遍缺乏，健康意识不强，感染各种传染性疾病的风险较高，故血液安全性相对较低。学历较低的献血者大多从事的职业可能是工人和农民等，生活和工作的健康环境相对较差，故高中以下低学历献血者的不合格率与工人/农民相一致。因此，在献血招募过程中优先选择文化程度高的群体。本研究中2018—2022年长沙地区无偿献血者中其他职业者占比最高，其血液检测总不合格率最高（2.40%），可能是因为该类人群没有稳定的工作，经济状况较差，加上自身文化程度较低，健康意识薄弱，故血液安全性差。因此，需要加强对该类人群的健康教育，提高其对输血传播疾病的认识和了解，增强自我保护意识，进而提高血液安全性。
综上所述，2018—2022年长沙地区无偿献血者血液检测总不合格率呈现逐年下降的趋势。ALT、HBsAg是造成血液检测不合格的主要原因，且不同人口学特征无偿献血者的血液检测不合格率存在显著差异。因此，为促进长沙地区无偿献血事业可持续健康发展，需要进一步完善血液检测技术和方法的准确性和灵敏度，优化采供血流程，进而提高检测结果的准确性，减少血液资源浪费和献血者流失；同时针对不同人群开展不同形式的健康宣教活动，提高无偿献血者对献血相关知识的认知，倡导积极健康的生活形式和加强献血前的征询体检和筛查工作，以降低本地区血液传染病的流行率和因非病理性ALT升高导致的血液报废；此外根据该地区无偿献血者血液检测不合格的分布情况制定个性化的献血招募策略，积极倡导女性、年轻人、学生/医务人员、高学历献血者等低风险人群献血，组建一支低危的献血队伍，提高血液检测合格率，进而保障临床用血安全。
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  • 湖南省自然科学基金项目(2021JJ70130)
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参考文献 引证文献
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2024年第51卷第6期
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doi: 10.20043/j.cnki.MPM.202311283
  • 接收时间：2023-11-15
  • 首发时间：2026-03-16
  • 出版时间：2024-03-25
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  • 收稿日期：2023-11-15
基金
湖南省自然科学基金项目(2021JJ70130)
作者信息
    1.长沙血液中心成分献血服务部，湖南 长沙 410001
    2.南华大学附属长沙中心医院检验科

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2种不同金属材料的力学参数
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Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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