济南地区无偿献血者梅毒血清学调查分析

梅毒是由梅毒螺旋体引起的慢性传染病,性传播为其主要途径,母婴垂直传播、输注含有梅毒螺旋体的新鲜血液均能引起该病感染。为保证输血安全,笔者对济南地区2001～2005年无偿献血者的梅毒感染状况进行了调查分析。现报告如下。     

140715人次无偿献血者血液检测分析

目的探讨有效降低无偿献者血液报废率的措施,杜绝高危人群献血。方法对2008—2010年乌鲁木齐市血液中心140715人次无偿献血者血液,按国家标准检测,对测出不合格的血液进行分类统计分析。结果参加无偿献血的140715人中,HBsAg、抗-HCV、抗-HIV、梅毒抗体、ALT项不合格有6016人次,不合格率占4．28％,其中检出ALT不合格占第一位。结论血液中心应认真进行献血者的健康征询,做好HBsAg初筛实验,全面开展ALT初筛实验,选择特异性好和灵敏度高的检测试剂,有效降低血液报废率,保证血液质量和临床输血安全。     

新疆巴州地区无偿献血者抗-HIV和梅毒阳性结果调查

近年从献血者中检出抗-HIV和梅毒阳性者检出率有逐年上升趋势,为确保血液质量,保证临床用血安全,笔者对1998年1月～2003年6月73 249名无偿献血者检测结果整理如下.     

2009年邯郸辖区无偿献血者血液感染指标调查

经血传播的疾病一旦感染给受血者,将给受血者带来极大的痛苦,甚至威胁生命。为保证对临床提供安全、有效的血液及血液制品,对无偿献血者所献血液进行严格的血液感染指标检测,是杜绝经血液传播疾病的惟一方法。现将2009年邯郸辖区血液检测不合格项目分析报告如下。     

初次献血者与重复献血者血液检测结果分析

目的:了解初次献血者与重复献血者输血相关传染病指标的情况,为建立一支健康、固定的无偿献血队伍提供科学依据.方法:对2005年1月～2005年12月盐城市无偿献血者的血液检测结果进行统计分析.结果:血液检测的阳性率,随着献血次数的增加而逐步下降,初次献血者为5.45%,2次献血者为3.39%,3次及以上献血者为2.77%,除谷丙转氨酶(ALT)差异不大外,其余4项差异有统计学意义.结论:重复献血者处于"窗口期"的危险性较低.     

2009-2011年常州地区无偿献血者血液检测结果分析

目的:分析常州市近3年来无偿献血者传染性疾病指标的筛查情况,为制定预防传染病输血传播、减少血液资源浪费政策提供科学依据。方法:对2009-2011年常州市无偿献血者的血液检测项目ALT、HB-sAg、抗-HCV、抗-HIV、TP进行分析。结果:3年共采集无偿献血标本131 693份,总不合格率为5.28%;各项目不合格率分别为ALT 3.74%,HBsAg 0.44%,抗-HCV 0.46%,抗-HIV 0.09%,TP 0.55%。各项指标不合格血液所占总报废血比例中ALT所占比例最高,达70.92%。结论:加强献血者传染性疾病指标检测,是在保证临床用血安全情况下提高血液资源利用率的重要措施。     

襄阳地区无偿献血者乙型肝炎病毒核酸检测效果分析

目的:分析核酸检测(NAT)献血者乙型肝炎病毒(HBV)结果,探讨血站全面开展NAT的必要性。方法:对我站酶免检测无反应性标本,采用PCR-荧光法进行NAT检测,NAT有反应性标本做HBV DNA定量和乙肝"两对半"检测。结果:NAT 31 443份标本,有反应49例(0.16%),其中,HBV DNA定量检测有反应性标本30例,"两对半"定性实验结果为22例HBsAg有反应性,14例HBsAg为临界值的标本,且其中32例合并HBeAb、HBcAb有反应性;13例HBsAb、HBeAb或HBcAb有反应性。结论:NAT能够在一定程度上弥补ELISA方法的局限性,有效缩短窗口期,防止亚型变异或者隐匿性肝炎漏检的风险,有必要在血站全面开展。     

南京地区无偿献血者RH阴性血液复检不合格情况分析

目的：分析南京地区无偿献血者中RH阴性血的检出结果和复检不合格情况,寻求减少稀有血型血液浪费的对策。方法：对2006-2011年间南京地区无偿献血者的血液标本进行检测,并对结果进行统计分析。结果：近年来RH阴性血比例有逐年下降的趋势,2011年有所回升。同时,其复检不合格率却呈现出逐年上升的趋势,由2006年的0．28％上升至2011年的1．92％。其中以HBsAg和ALT不合格为主要报废原因。在不合格人群中,报废血量为200ml的人数逐年上升,但总体仍以捐献300ml、400ml为主,其中非固定与固定献血者比例为19：7。不合格群体分布以来自南京郊县的青壮年已婚男性为主,但近年来呈现出高学历以及南京地区外来人群报废情况增加的趋势。结论：减少RH阴性血液报废,不仅需要提高检测试剂质量,规范人员操作;同时需要加强宣传招募工作,尤其加强对于重复献血者的招募,及时招募暂时淘汰成员归队,促进稀有血型献血工作的可持续发展。     

策略调整前后无偿献血者血液检测结果分析

目的:了解策略调整对降低不合格率的效果。方法:对乐山市无偿献血者5项血液检测结果进行统计分析,获得无偿献血者健康状况及血液检测不合格原因的资料。结果:2010-2012年血液检测总不合格率为6.47%,分项不合格率:ALT(4.35%)抗-TP(0.98%)HBsAg(0.80%)抗-HCV(0.54%)抗-HIV(0.07%),其中ALT与抗-TP为主要不合格原因:2012年全面实行献血前ALT快速初筛检测,并对应急预案进行优化后,总不合格率较2011年呈明显下降趋势,差异有统计学意义(χ2=145.118,P0.01)。结论:策略调整有效。针对乐山市不断增长的用血需求,加强无偿献血前的健康征询,在献血者采血前已有HBsAg以及ALT快速初筛项目的基础上,考虑有针对性地增加抗-TP快速初筛项目,可进一步降低血液不合格率。     

自愿无偿献血者血液报废原因调查研究

目的：调查自愿无偿献血者血液报废主要原因,采取有效措施防止和降低血液报废率。方法：对2005-2007年报废的自愿无偿献血者血液进行分品种、分项目统计和分析,找出血液报废的主要原因。结果：自愿无偿献血者血液中全血和红细胞类报废主要原因是丙氨酸转移酶（ALT）,血浆报废的主要原因是脂肪血浆。结论：要降低自愿无偿献血者血液报废率,必须加大无偿献知识的宣传力度,让每一个献血者知道献血前吃清淡饮食,忌食含脂肪过多的食物,采用街头ALT筛查,可提高血液质量,降低自愿无偿献血者血液报废率。     

False positive viral marker results in blood donors and their unintended consequences

False positive (FP) viral marker results in blood donors continue to pose many challenges. Informing donors of FP results and subsequent deferral can result in stress and anxiety for donors and additional complexity and workload for blood services. Donor management strategies need to balance the requirement to minimise donor anxiety and inconvenience while maintaining sufficiency of supply. Decisions about how and when to inform donors of FP results and determine deferral periods can be difficult as FP results, while often transitory, can take up to several years to resolve. Additional complexities include the interpretation of indeterminate serological confirmatory testing without detectable viral RNA or non‐discriminated NAT results with concomitant anti‐HBc reactivity ‐ both may be due to FP results, but the former may also represent past infection and the later may represent occult hepatitis B infection. In this review we discuss strategies to minimise indeterminate serological confirmatory results, possible donor deferral policies and the impact on donors when notified of FP results. We also provide some new data from Australia that address the challenge of interpreting non‐discriminated NAT results with concomitant anti‐HBc reactivity. Ultimately, the challenge is for each blood service to develop appropriate strategies for donor management, taking into account local information and requirements.     

台州市无偿献血者艾滋病病毒抗体阳性情况调查

目的:了解台州地区无偿献血人群艾滋病病毒(HIV)感染特征及感染途径。方法:统计2010-01-2013-09台州市无偿献血者HIV感染率,分析HIV感染者情况。结果:台州市献血人群中HIV感染者24例,平均感染率为0.014%。结论:在进行献血者筛选时,对多次献血者也应认真做好献血前咨询、体检,应慎重甄别和界定低危人群。     

2006—2008年上海地区无偿献血者重复献血血液筛查结果分析

目的：了解上海地区无偿献血者再次献血的情况,以采取措施提高血液质量、保障输血安全。方法：2006年2月-2008年1月期间,对上海地区参加无偿献血的合格献血者再次献血情况进行跟踪;将重复献血者的第2次献血筛查结果与整体献血人群进行分类比较。结果：上海地区565 360位献血者中有516 011位（91.27%）首次献血筛查结果为合格,合格者中57 791（11.20%）位献血者再次参加献血;再次献血人群中ALT、HBsAg、抗-HCV、抗-HIV、梅毒不合格比例及总体不合格人数比例分别为2.68%、0.11%、0.07%、0.02%、0.09%和3.00%,显著低于整体献血人群（P〈0.01）。结论：重复献血的无偿献血者是低危献血人群,应加大重复献血者队伍的组建力度,保障血液安全。     

Blood donors on teratogenic drugs and donor deferral periods in a clinical situation

Deferral of blood donors taking teratogenic drugs is critical. From March 2008 to January 2009, we analysed stored blood specimens from donors who had taken teratogenic drugs and whose blood was transfused to women of childbearing age to determine the plasma concentration at the time of donation using high-performance liquid chromatography. In total, 167 specimens were examined. The numbers of specimens exceeding the quantification limit were 7, 39, 4, 2 and 1 for finasteride, isotretinoin, acitretin, etretinate and dutasteride, respectively. Finasteride was beyond the recommended drug deferral period in one specimen. These results may help create practical deferral policies.     

Sexual behaviour of Croatian blood donors as a threat to the health of blood recipients

Background

In this cross-sectional study we assessed the prevalence of the various blood safety sexual risk behaviours among blood donors from East Croatia and the possibilities for improving the present blood donor screening procedure.

Materials and methods

The study included 423 blood donors of both sexes who completed a specially designed anonymous questionnaire immediately after their blood donations. The questionnaire contained questions on demographic data, sexual preferences, and possible sexual risk behaviours in the period before the blood donation.

Results

The study revealed that the most common forms of sexual risk behaviour among Croatian blood donors had been irregular condom use during sexual contacts with new partners (294/423; 69.5%) and five or more sexual partners during the lifetime (213/423; 50.4%). More male than female subjects had had five or more sexual partners during their lifetime (p<0.0001). Compared to married donors, single subjects more frequently reported sexual contacts without using a condom with their new partners in the period from the last blood donation (p<0.0001) and also in the period of 1 month before current blood donation (p=0.0060). A larger number of younger than older subjects had practiced different types of sexual intercourses during the lifetime (p=0.0002) but more older than younger subjects reported irregular use of condom on sexual contacts with a new partner during their lifetime (p=0.0231).

Conclusion

Blood donors who were involved in various forms of sexual risk behaviour represent a serious threat to the health of blood recipients. In this respect a new approach to blood donor screening procedure with additional questions on sexual behaviour in anonymous donor questionnaires would improve the safety of transfusion treatment in East Croatia.     

多次机采血小板对献血员血常规的影响

目的：监测机采血小板献血者的血常规,评估多次机采血小板对献血者健康状况的影响。方法：分别检测献血者献血前和献血后1个月和6个月血常规,并进行对比分析。结果：白细胞计数、淋巴细胞比率、单核细胞比率、中性粒细胞比率、淋巴细胞计数、单核细胞计数和血小板计数等血液常规项目在机采血小板前后没有明显改变。结论：体检合格的血小板献血者,定期单采血小板对献血员的血常规和健康状况没有明显影响。     

献血者HIV的筛查模式探讨

目的:通过酶联免疫吸附试验(ELISA)第3代、第4代试剂与NAT的不同组合模式的比较,评价和探讨HIV核酸检测的意义,选择适合无偿献血者血液筛查HIV的检测模式。方法:采用第3代和第4代2种ELISA试剂与NAT(诺华单人份检测)平行检测无偿献血标本,初筛HIV阳性标本送市疾病预防控制中心确证。结果:采用ELISA第3代试剂、NAT或(第3代试剂+NAT)组合检测,假阳性率均较低,而特异性均较高,假阳性率分别为0.01%、0、0,特异性分别为99.99%、100%、100%;而所有含ELISA第4代试剂的筛查模式其假阳性率均较高,而特异性均较低,与前者相比差异有统计学意义(P0.01)。采用1种ELISA试剂或2种(3代+4代)联合检测模式,灵敏度均为87.50%,而NAT灵敏度为100%。ELISA试剂与NAT组合检测互补性相对较好;NAT在检出窗口期的HIV感染方面具有优势,其早期检测灵敏度优势可替代ELISA第4代试剂。结论:采用第3代ELISA试剂与NAT同时筛查HIV具有较高的可靠性,可降低经血源传播HIV的风险;同时减少假阳性,避免血液资源浪费。