广州市无偿献血者中抗-HCV阳性人群的比较分析

目的了解广州市不同性别、年龄以及不同职业的无偿献血者抗-HCV阳性率情况。方法对从2000年1月～2010年12月的2 520 179(人)份广州市无偿献血者的血液标本,采用ELISA做抗-HCV双试剂检测并对检测结果做统计学分析。结果广州地区无偿献血者抗-HCV阳性率为0.42%(10 570/2 520 179),且在不同性别、年龄、职业之间差异具有统计学意义(P0.05)。女性抗-HCV阳性率(0.29%)低于男性(0.52%);35岁[18～25岁(0.40%);25～35岁(0.36%)]较≥35岁[35～45岁(0.54)%,45～55岁(0.52%)]的献血者的抗-HCV阳性率低;工人(0.56%)和无职业者(0.76%)的抗-HCV阳性率比较高,医务人员血样中未检出抗-HCV阳性。结论广州市无偿献血人群中抗-HCV阳性率较低,符合献血条件的≤35岁的人群积极献血将有利于保障临床输血安全;宜加强对工人和无职业者献血安全和输血相关病毒知识的宣传和教育。     

济南市无偿献血人群血液检测结果分析

目的分析济南市无偿献血人群血液检测结果。方法对2001年至2007年10月所采集全部无偿献血者的血液样本采用双人、双试剂进行ALT、HBsAg、抗-HCV、抗-HIV、梅毒抗体和不规则抗休的初检和复检。抗-HIV不合格者均经山东省疾病控制中心HIV确证实验室确认。结果历年来无偿献血者的血液检测结果总不合格率平均为5.77%,且总体呈下降趋势。ALT、HBsAg两项为不合格最主要原因。在不合格项中,不规则抗体确有一定发生率。结论应继续加强无偿献血宣传,建议开展采血前HBsAg与ALT快速检测,有条件血站对献血者进行不规则抗体筛选。     

Age-dependent prevalence of vascular disease-associated polymorphisms among 2689 volunteer blood donors

BACKGROUND: The development of vascular disease involves the interaction of genetic and environmental factors. Because vascular disease is a major contributor to mortality in Western societies, we hypothesized that deleterious polymorphisms associated with hemostasis decrease in frequency among a healthy population as a function of age. METHODS: The frequencies of factor V G1691A Leiden (FVL), factor II (FII) G20210A, methylenetetrahydrofolate reductase (MTHFR) C677T, glycoprotein Ia (GPIa) C807T, glycoprotein IIIa (Pl(A1)/Pl(A2)) T1565C, and angiotensin-converting enzyme (ACE) intron 16 insertion/deletion (I/D) alleles were determined among 2689 healthy Caucasian whole-blood donors. For analysis, participants were divided into three age groups: 17-39 years (n = 979; 505 males and 474 females), 40-59 years (n = 900; 526 males and 374 females), and 60-85 years (n = 810; 530 males and 280 females). RESULTS: The Pl(A2) allele frequency decreased from 17.5% to 15.7% and 14.1% in the 17-39 years, 40-59 years, and 60-85 years age groups, respectively (n = 5094 alleles; P = 0.025). Among ACE DD males, the Pl(A2) allele frequency decreased from 20.8% to 16.1% and 9.1% in the same groups, respectively (n = 810 alleles; P = 0.001). No statistically significant decrease in genotype or allele frequency was observed among carriers of FVL, FII 20210A, MTHFR 677T, GPIa 807T, or ACE D. CONCLUSIONS: These data suggest that Pl(A2) carriers, especially those who are ACE DD, are statistically less prevalent among older healthy blood donors compared with their younger counterparts. These observations suggest an important, deleterious, time-dependent impact of the Pl(A2) allele, as well as the ACE DD/Pl(A2) allelic combination, on overall health and longevity.     

某地区无偿献血者中性粒细胞特异性抗体筛查分析

目的探讨河南地区无偿献血者中性粒细胞特异性(HNA)抗体的分布和特异性,分析HNA抗体引起的免疫性输血不良反应。方法随机收集女性标本156例,男性标本80例,采用LABScreen Multi试剂盒对标本HNA抗体进行检测。结果 236例无偿献血者中,女性HNA抗体检出阳性率为5.77%(9/156),男性为5.00%(4/80)。其中HNA 1A者7例,HNA4A者4例,同时检出HNA 1A和HNA 4A、HNA 1A和HNA 1C各1例。结论 HNA抗体分布无性别差异,研究HNA抗体的分布和特异性,可为指导临床用血安全和相关政策的制定提供有力的理论基础。     

张家界市无偿献血者梅毒血清学状况的初步调查

为了解张家界市无偿献血者梅毒流行状况及其对血液质量的影响 ,笔者检测了 6 1 6 0份初次献血的无偿献血者血液标本 ,并对其中梅毒阳性者的性别、年龄、职业等情况进行分析 ,现报道如下。1　材料与方法1 .1　标本来源　 1 999～ 2 0 0 2年 9月本市各单位、街头无偿献血者血液标本 6 1 6 0 (人 )份 ,其中男性 342 2份 ,女性 2 738份。1 .2　仪器　Elx 80 0酶标仪 (美国宝特公司 ) ;洗板机 (芬兰雷勃公司 ) ;XK95 1型多用振荡仪。1 .3　梅毒检测方法　所有标本均采用RPR及ELISA法 (上海科华和北京万泰公司试剂盒 )检测 ,严格按照试剂盒…     

青岛地区无偿献血人群HIV筛查结果回顾性调查

目的了解和掌握青岛地区无偿献血人群HIV感染情况,比较分析3种检测方法的结果,为加强血液管理提供决策依据。方法将本中心2013年6月14日-2014年6月14日采集的血液样本100 885人份进行血清学检测,其中99 637例ALT正常,TP抗体阴性的献血者样本进行了NAT,抗-HIV初筛阳性样本送往市疾病控制中心做确证实验,对3种方法的检测结果进行回顾性分析。结果抗-HIV反应性59例(阳性率为0.06%),其中抗-HIV和核酸同时反应性16例(阳性率为0.016%),43例抗-HIV单项反应性,未检出HIV核酸单项反应性样本,59例经确证阳性18例(感染率为17.84/10万),1例不确定,其中16例抗-HIV和核酸同时反应性样本经确证全部HIV阳性,43例抗-HIV单项反应性确证阳性2例,1例不确定。在16例血清学反应性(S/CO值大于15)、NAT阳性样本中,核酸检测的阳性预测值为100%。流行病学调查发现18例确证阳性献血者全部为男性,未婚11例(61.11%),已婚6例(33.33%),1例不祥;首次献血者8例(44.44%),重复献血者10例(55.56%)。结论 NAT的假阳性率远远低于血清学检测方法,针对HIV感染检测准确度高。为了保证血液质量和输血安全,除了加强实验室管理,提高HIV检测水平,我们应积极普及无偿献血知识和艾滋病相关知识的宣传教育,加强未婚男性青年的艾滋病防治工作。     

广州地区抗-HCV阳性献血者核酸检测及随访

目的探讨广州地区无偿献血人群HCV感染者自然转归的相关因素。方法对ELSIA法检测为抗-HCV阳性的193名献血者采用荧光定量PCR法检测其HCV RNA,半年后随访并再次做抗-HCV和HCV RNA检测。结果 193名未经治疗的抗-HCV阳性献血者随访前后2次检测的HCV RNA及抗-HCV结果无变化;分别按性别、年龄比较其HCV RNA阳性比例:男性为60.5%(69/114)、女性为34.2%(27/79)(P0.01),35～55岁组为60.9%(42/69)、18～35岁组为43.5%(54/124)(P0.05)。结论女性HCV感染者的自然转归明显好于男性感染者,18～35岁HCV感染者的自然转归优于35～55岁感染者,提示性别及年龄均为HCV感染者自然转归的影响因素。     

广州地区首次参加无偿献血人群HCV感染的流行病学调查

目的了解广州地区首次参加无偿献血人群HCV的感染状况。方法抗-HCV检测采用酶联免疫吸附实验(使用2种不同厂家的试剂盒),HCV RNA检测采用荧光定量PCR法,ALT检测采用速率法。结果2004—2007年在广州血液中心首次参加无偿献血的559890名献血者中,1617名经双试剂检测抗-HCV阳性,阳性率为0.289%。随机选取435名双试剂检测抗-HCV阳性血液标本进行RNA检测,266名阳性,占61.15%,男女(P<0.01)HCV RNA阳性率有统计学意义(P<0.01)。266名抗-HCV检测阳性献血者中,ALT升高(>40U)的为18名(其中男性17名),不合率为6.77%,男女ALT的不合格比有统计学意义(P<0.01)。结论随着无偿献血的开展,献血人群中HCV的阳性率不断下降;不同性别的个体清除HCV的能力不同,女性高于男性。     

广州地区无偿献血者HCV基因分型与病毒滴度的相关性研究

目的 探讨丙型肝炎病毒(hepatitis C virus,HCV)6a亚型与病毒滴度的关系.方法 从2009年11月～2011年8月收集广州地区无偿献血人群中抗-HCV阳性标本527份,对其进行HCV核酸检测(nucleic acid test,NAT).对核酸阳性的标本采用罗氏COBAS AmpliPrep/COBAS TaqMan HCV test进行病毒滴度的定量检测,以及采用NS5B基因扩增和直接测序法进行HCV基因分型的鉴定.对于标本的病毒滴度与基因分型采用SPSS16.0软件进行关联性分析.结果 527份抗-HCV阳性标本中,299份标本成功获得病毒滴度和分型结果.HCV 1型(1a+1b)、2型(2a)、3型(3a +3b)和6型(6a)的比例分别为48.8％,8.7％,12.4％和30.1％.统计分析结果表明,不同基因型之间的病毒滴度存在显著差异(F=6.675,P＜0.01).HCV 1型和6型的平均滴度分别为6.04,6.15 log10 IU/ml,均高于2型和3型(平均滴度分别为5.66和5.49 log10 IU/ml).结论 HCV 1b和6a是广东地区无偿献血者人群中流行的主要亚型.HCV 1型(1a +1b)和6型(6a)的病毒滴度显著高于2型和3型.HCV 6a在广东地区的流行和传播可能其较高病毒滴度有关.研究HCV基因分型与病毒滴度的关系的研究有助于广东地区HCV的防控策略以及各亚型治疗方案的制定.     

无偿献血者中HIV阳性者的病毒载量分析

目的分析无偿献血者艾滋病病毒(HIV)阳性标本的病毒载量水平及无偿献血人群HIV的携带状态,为评估无偿献血人群HIV感染风险提供依据。方法收集2016—2018年国内25家血站HIV筛查反应性(R)的血浆标本683(人)份,根据HIV反应性类型分为ELISA双试剂反应性组(ELISA R-R)、核酸检测(NAT)反应性组(NAT R),ELISA单试剂反应性组(ELISA R-NR),使用电化学发光试剂法做HIV抗原抗体检测,使用核酸定量试剂做HIV RNA定量检测,核酸定量检测低于检测下限(80 IU/mL)的标本以WB法确认。结果本组无偿献血者筛查R标本中,1)HIV确认阳性率为27.1%(185/683),确认阳性样本ELISA R-R标本占89.2%(165/185),ELISA NR-NR+NAT-R占8.1%(15/185),ELISA R-NR占2.7%(5/185),3(种)组病毒载量(IU/mL)分别集中在10~(4.605±0.047)、10~(3.472±0.328)和10~(5.196±0.655)(P0.05);HIV窗口期标本病毒载量(IU/mL)10~5者占20.0%(4/20),其中2例来自ELISA R-NR组,2例来自NAT R组;30.0%(6/20)为10~4者,其中2例来自ELISA R-NR组,2例来自NAT R组;其余50.0%(10/20)为10~1—10~3者,其中1例来自ELISA R-NR组,剩余9例来自NAT R组。2)在HIV确认阳性者中发现3名疑似HIV精英控制者(ECs)。结论我国无偿献血者中HIV ELISA R-R感染者病毒载量较抗原抗体窗口期感染者高;HIV窗口期感染者中多为低载量病毒感染者。疑似HIV ECs的发现揭示我国无偿献血人群HIV感染状态日益复杂多样化,需要加强对血液筛查实验室检测质量的管理,探究更合理的HIV筛查策略。     

Human T-cell lymphotropic virus in volunteer blood donors

Serum samples collected in 1985 and 1986 from 18,257 donors to the Greater New York Blood Program were screened by enzyme-linked immunoassay for antibody to human T-cell lymphotropic virus (anti-HTLV). Fifteen samples (0.08%) were confirmed positive: 7 by radioimmunoprecipitation assay (RIPA) alone, 6 by Western blot alone, and 2 by combined results from both tests. One donor, whose original test result was uninterpretable because multiple nonspecific bands were present on RIPA, clearly tested positive on subsequent specimens. Follow-up testing of individuals with this type of result may be needed to resolve their HTLV status. Anti-HTLV prevalence increased with age and was significantly more common in black or Hispanic donors and in those born in the Caribbean than in other donors. All anti-HTLV-positive donors were negative for antibody to HIV-1, and only one donor (7% of those positive) would have been excluded by any of the routine donor screening tests used at that time.     

北京地区无偿献血人群中SARS流行病学调查

目的　明确严重急性呼吸综合征冠状病毒是否在北京疫区无偿献血人群中存在感染 ,为制订预防输血传播SARS的相关规定提供流行病学依据。方法　对 4 6 19份标本 (含SARS冠状病毒流行期北京疫区街头无偿献血人群血液筛查标本 2 35 7份 ,非流行期北京市街头无偿献血者人群留样标本 10 79份 ,流行期非疫区山东、湖南外调血无偿献血标本 1183份 ) ,作SARS冠状病毒IgM、IgG以及总抗体检测 ,对初筛阳性结果采用献血者追踪咨询和核酸检测的方法确认 ,用统计学方法分析最终的检测结果。结果　SARS流行期间北京疫区献血人群中未见SARS冠状病毒隐性感染者和出现流行感染情况。结论　预防经血传播SARS冠状病毒的重点应放在献血者征募和健康检查咨询方面 ,而非血液中SARS冠状病毒标记物的筛查。     

Assessment of donor fear enhances prediction of presyncopal symptoms among volunteer blood donors

BACKGROUND: Fear is an important contributor to the risk of presyncopal reactions to blood donation. However, concern that asking donors about their fears may increase the risk of reactions is a potential impediment to incorporating fear assessment into donor screening. STUDY DESIGN AND METHODS: Before donation, participants responded to a series of questions that either did (n = 488) or did not (n = 494) include questions related to fear of seeing blood drawn. Immediately after donation all participants provided ratings of presyncopal reactions. RESULTS: Among those asked predonation fear questions, fear was most strongly related to presyncopal symptoms when compared against other donor characteristics (e.g., age, number of prior donations, body mass index, estimated blood volume, blood pressure, and pulse). However, Mann‐Whitney U tests revealed that being asked about fear before donation was not associated with higher reports of presyncopal reactions for the sample as a whole, nor among novice donors. Further, regression analyses indicated that fear remained a significant predictor of presyncopal reactions in final models that included age and number of prior donations as significant predictors. CONCLUSION: Predonation assessment of fear of blood draws may help to identify donors who are most likely to benefit from brief interventions designed to enhance donor coping, reduce risk of presyncopal reactions, and increase donor retention.     

青岛地区无偿献血者血液病毒核酸检测的研究

目的调查青岛地区现有的血液检测体系是否存在输血传播HBV、HCV和HIV的残余风险。方法对无偿献血者样本ELISA法检测HBsAg、抗-HCV和抗-HIV的同时,应用NAT技术检测HBV、HCV和HIV。NAT检测阳性ELISA HBsAg阴性或NAT检测阴性ELISA HBsAg阳性的样本,进一步跟踪确认。结果12 000人份无偿献血者血样未发现ELISA法检测抗-HCV和抗-HIV阴性,NAT检测HCV和HIV阳性的情况,发现2例HBV DNA阳性HBsAg阴性。1例HBV DNA阳性,乙肝免疫检测HBsAg、抗-HBs、HBeAg、抗-HBe和抗-HBc均为阴性,跟踪11周后采血检测HBV DNA阳性,HBsAg、HBeAg和抗-HBc阳性。另1例HBV DNA阳性,乙肝免疫检测HBsAg、抗-HBs、HBeAg、抗-HBe均为阴性,抗-HBc为阳性,跟踪3周后采血检测,2次检测结果相同,HBV DNA定量检测均为1000IU/ml左右的低含量。结论现有的血液检测体系存在输血传播HBV风险,原因可能为HBV的免疫"窗口期"、隐匿性HBV感染等,建议现有的血液检测体系下,为了阻断HBV的输血传播,增加HBV的病毒核酸检测和抗-HBc检测。     

Racial and ethnic composition of volunteer cord blood donors: comparison with volunteer unrelated marrow donors

BACKGROUND: Umbilical cord blood is an alternative peripheral blood progenitor cell source for patients who need transplantation. A presumed advantage of cord blood is the ability to increase minority recruitment. STUDY DESIGN AND METHODS: The racial composition of five member cord blood banks of the National Marrow Donor Program (NMDP) was compared, representing 9020 cord blood donors with NMDP marrow donors from comparable geographic areas, representing 417,676 donors. Cord blood and marrow donors self-reported racial designations on questionnaires. Donor statistics were compared with baseline racial data of deliveries from participating hospitals for cord blood donors and with geographic census data for marrow donors. RESULTS: The California, Florida, and Massachusetts cord blood banks recruited a lower percentage of minorities than the corresponding marrow donor centers. In New York and Colorado, minority recruitment was equivalent. In California, Florida, Massachusetts, and New York, the cord blood banks recruited a lower percentage of minorities than those delivering at the respective hospitals. The cord blood banks in California, Colorado, Florida, and Massachusetts recruited a lower percentage of minorities compared with delivery data than the corresponding marrow donor centers compared with census population (p < 0.001). In New York, the percentages were similar. CONCLUSION: The problem of insufficient minority recruitment of cord blood has not yet been solved. Better strategies are needed to recruit minority donors.     

Vasovagal reactions in blood donors

The donor records of a hospital blood bank, analyzed from a statistical standpoint demonstrated a low incidence of vasovagal reactions: 119 in 10,547 donations (1.13%). Donors of younger age and of lower diastolic blood pressure were more prone to reaction. There was no significant sex difference. Higher reaction rates were also associated with first- time donation, the time of year (spring), and a particular phlebotomist. The low reaction rate and the clearly demonstrated psychologic factors in the present study were attributed to a reflection of the small amount (200 ml) of blood withdrawn. The importance of the phlebotomist-donor relationship was stressed.     

海南地区无偿献血者不规则抗体筛查结果分析

目的调查分析本地区无偿献血者不规则抗体的发生频率和分布特点。方法随机抽取本中心2010年1月-2014年6月,无偿献血者血液标本344 148例,应用盐水法、凝聚胺法和抗球蛋白法筛查献血者不规则抗体。结果 344 148名无偿献血者中共检出不规则抗体78例,阳性率0.0227%。女性不规则抗体的检出率(0.0431%)明显高于男性(0.0129%)(P0.05)。抗体阳性献血者,以18-24岁年龄段人群比率最高,达到47.44%。检出的不规则抗体包括ABO亚型16例,抗-M 9例,抗-D 3例,抗-P11例,抗-Tja1例,冷自身抗体20例和非特异性不规则抗体28例。结论海南地区无偿献血人群中有一定比例的红细胞不规则抗体检出率,因此加强和重视不规则抗体筛查和鉴定工作,对保障临床安全用血具有重要意义。     

乌鲁木齐地区无偿献血者HCV感染及合并HIV感染状况的调查研究

目的了解乌鲁木齐地区无偿献血者HCV感染及合并HIV感染状况及流行病学特点,探讨血液质量和无偿献血人群特点的关系,为减少HCV经血液传播、预防和控制HCV输血风险提供依据。方法收集2008年1月1日至2010年12月31日在乌鲁木齐血液中心的献血者的一般资料及指标抗-HCV、抗-HIV血液检测结果。结果共调查140 665例献血者,其中男86 179例,占61.27%,女54 486例,占38.73%,年龄范围18~55周岁。血液检测指标不合格率分别为抗-HCV 5.52‰和抗-HIV 2.34‰。结论建立一支固定的无偿献血队伍、加强临床科学用血等是提高血液安全的有效途径。