长沙地区2015~2019年无偿献血者血液报废原因分析

曾凡智 陈静 邓叶华 赵飞雪

[摘要]目的 了解长沙地区2015～2019年无偿献血者血液筛查不合格情况的原因，寻求减少血液浪费的方法与策略。方法 收集2015～2019年长沙地区762 845份血液标本检测结果，并对其进行回顾性分析。结果 2015～2019年长沙地区无偿献血总人次为762 845人次，年采血量逐年呈上升趋势，年不合格率基本持平。总不合格人次为14 646人次，不合格率为1.92%。乙肝表面抗原（HBsAg）和丙氨酸氨基转移酶（ALT）为近5年血液报废最主要的两个因素。其中，不同年份的HBsAg、丙型肝炎病毒抗体（抗-HCV）、人类免疫缺陷病毒抗体/抗原（抗-HIV/HIV抗原）、ALT不合格率比较，差异有统计学意义（P<0.05）。结论 长沙地区近5年血液筛查不合格情况与相应疾病流行趋势基本相符;建立一支低危且固定的献血队伍，有利于降低血液报废率;为减少由于假阳性所导致的血液报废，应严格血液初步筛查标准，使用特异性更好的试剂。

[关键词]无偿献血;血液筛查;血液报废;不合格率

[中图分类号] R446.6          [文献标识码] A          [文章编号] 1674-4721（2020）7（a）-0187-03

Analysis of the causes of blood discarding of voluntary blood donor in Changsha region from 2015 to 2019

ZENG Fan-zhi   CHEN Jing   DENG Ye-hua   ZHAO Fei-xue▲

Department of Laboratory， Changsha Blood Center， Hu′nan Province， Changsha   410000， China

[Abstract] Objective To understand the causes of unqualified blood screening of voluntary unpaid blood donors in Changsha region from 2015 to 2019， looking for methods and strategies to reduce blood waste. Methods The test results of 762 845 blood samples in Changsha region from 2015 to 2019 were collected and analyzed retrospectively. Results From 2015 to 2019， the total number of voluntary blood donors in Changsha region was 762 845. The annual blood collection showed an increasing trend year by year， and the annual unqualified rate was basically flat. The total number of unqualified persons was 14 646， and the unqualified rate was 1.92%. Hepatitis B surface antigen （HBsAg） and alanine aminotransferase （ALT） were the two main factors for scrap of blood sample in the past 5 years. There were statistically significant differences in the unqualified rates of HBsAg， hepatitis C virus antibody （anti-HCV）， human immunodeficiency virus antibody/antigen （anti-HIV/HIV antigen）， and ALT in different years （P<0.05）. Conclusion The unqualified blood screening in Changsha region in the past 5 years is basically consistent with the epidemic trends of corresponding disease. The establishment of a low-risk and fixed blood donation team is conducive to reducing the rate of blood scrapping. In order to reduce blood scrapping due to false positives， the preliminary blood screening criteria should be strict， and reagents with better specificity should be used.

[Key words] Voluntary blood donation; Blood screening; Blood scrapping; Unqualified rate

近年來，随着人们生活质量和临床医疗水平的逐步提升，临床用血供不应求已成为现阶段临床用血机构与采供血机构之间的主要矛盾。而各采供血机构为尽力满足临床的用血需求，除了逐年稳步提高采血量之外，也在努力寻求减少血液浪费的改进措施。因此在保证血液质量安全的同时，尽可能地降低血液报废率，节约血液资源成为各采供血机构的首要任务和根本宗旨。本研究旨在通过对长沙地区2015～2019年无偿献血者血液筛查结果进行回顾性分析，统计近年来长沙地区无偿献血者血液各项检测不合格的分布情况，根据其特点和发展规律，探讨导致血液报废可能存在的客观原因，为以后的持续改进工作提供理论基础和科学依据，现报道如下。……