北京某医院五种血源检测结果对比分析
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摘要
目的对比分析2013-2017年某医院献血中心采集的5种血源的检测结果数据,提出优化采血工作模式,减少血液不合格率的建议。方法收集2013～2017年某医院院内团体献血、院外团体献血、成分献血、街头采血、互助献血五种血源ALT及血液感染性指标HBsAg、抗-HCV、抗-HIV、抗-TP数据进行统计分析。结果 2013～2017年五种血源标本共198662例,互助献血人群血液不合格率最高,其次是街头采血;5项检查中ALT不合格率居第一,其次为HBsAg;初筛可以有效降低采血后血液不合格率,其差异具有统计学意义。结论优化献血流程,加强质量管理和规范操作,确保输血安全,减少浪费。
Objective To compare and analyze the data of 5 types of blood sources collected by Blood Donation Center from 2013 to 2017, so to provide reference to optimize the blood collection mode and reduce the unqualified rate. Methods We analyzed the date of ALT, HBsAg,anti-HCV, anti-HIV, and anti-TP from five types of blood sources, including the group blood donations within and outside the hospita, component blood donation, street blood collection and mutual-aid blood donation from 2013 to 2017. Results From 2013 to 2017,198662 samples were collected. For the mutual-aid blood donation, the unqualified rate was the highest, while the second was street blood collection. ALT took the first place in all unqualified indicators from the 5 tests, followed by HBsAg. The primary screening could effectively reduce the blood unqualified rate after the blood collection, with significant difference. Conclusion Our study demonstrate the importance of following principals: optimizing the blood donation process, strengthening the quality management and standard operation, ensuring the safety of blood transfusion and reducing the potential waste.
Objective To compare and analyze the data of 5 types of blood sources collected by Blood Donation Center from 2013 to 2017, so to provide reference to optimize the blood collection mode and reduce the unqualified rate. Methods We analyzed the date of ALT, HBsAg,anti-HCV, anti-HIV, and anti-TP from five types of blood sources, including the group blood donations within and outside the hospita, component blood donation, street blood collection and mutual-aid blood donation from 2013 to 2017. Results From 2013 to 2017,198662 samples were collected. For the mutual-aid blood donation, the unqualified rate was the highest, while the second was street blood collection. ALT took the first place in all unqualified indicators from the 5 tests, followed by HBsAg. The primary screening could effectively reduce the blood unqualified rate after the blood collection, with significant difference. Conclusion Our study demonstrate the importance of following principals: optimizing the blood donation process, strengthening the quality management and standard operation, ensuring the safety of blood transfusion and reducing the potential waste.
引文
[1]王锐,韩玲,赵伟萍.20例输血感染案例引起的思考[J].中国输血杂志,2002,15(3):216-218.
[2]国杰,张婷,桂萍,等.北京某医院2012-2016年无偿献血者血液感染性指标检测结果分析[J].标记免疫分析与临床,2017,24(9):967-972.
[3]卫生部血液标准专业委员会.血液筛查丙氨酸氨基转移酶临界值变更专题研讨会纪要[EB/OL].(2013-05-23)[2014-01-14]. http://www. jsblood. com. cn/artiele. php? id=2386.
[4]张研,文国新,刘金保.自愿无偿献血者ALT升高与非病理影响因素的相关性研究[J].中国输血杂志,2013,26(2):156-158.
[5] ALTERH J. Transmitted hepatitis C and non-A non-B NON-C[J].Vox Sang,1994,67(3):19-24
[6] KLEIN H G. Controversies in transfusion medicine ALT screening of blood donors[J]. Pro Transfusion, 1990,30(4):363.
[7]邬旭群.无偿献血者丙氨酸氨基转移酶检测的意义[J].广东医学.2002,23(8):840-841.
[8] BRINKMANN T, DREIER J, DIEKMANN J, et al. Alanine aminotransferase cut-off values for blood dinor screening using the new International Federation of Clinical Chemistry reference method at 37 degrees C[J].Vox Sanguins, 2003,85(3):159-164.
[9]桂萍,张婷,乔木,等.丙氨酸氨基转移酶的临界值改变对献血者血液筛查的影响[J].临床输血与检验,2015, 17(5):466-467.
[10]刘玉振,邢培清,李伍升,等.无偿献血人群中ALT、抗-HCV和HBsAg阳性模式分布调查[J].解放军预防医学杂志,2004,22(4):278-279.
[11]王瑞,黄力勤,张婧,等.实施核酸检测后重新评估献血者ALT的检测功效[J].中国输血杂志,2017,30(9):1034-1038.
[12]梁晓峰,陈园生,王晓军.中国3岁以上人群乙型肝炎血清流行病学研究[J].中华流行病学杂志,2005,26(9):655-658.
[13] BATES I,MANYASI G,LARAA M. Reducing replacement donors in Sub-Saharan Africa:challenges and affordability[J]. Transfus Med,2007,17(6):434-442.
[14] BIANCO C. Difficult blood donor choices:dance, feast or donate blood?[J].Rev Bras Hematol Hemoter,2013,35(4):225-241.
[15]朱燕霞,钱宝华,查占山,等.流动采血车无偿献血血液情况分析[J].中国输血杂志,2008,21(2):126-127.
[16]丁左红,蔡莉.成分献血者体检、初筛不合格原因分析[J].临床输血与检验,2015,17(5):461-462.
[17]王迅.采供血机构开展血液病毒核酸检测的条件及意义[J].中国输血杂志,2008,21(11):825-826.
[18]刘胡敏,陈传敏,高加良,等.ELISA结合核酸检测技术对献血者血液筛查结果分析[J].中国输血杂志,2013,26(5):456-457.
[19] BUSCH M P. HIV, HBV, and HCV:new developments related to transfusion safety[J]. Vox Sang,2000,78(suppl2):253-256.
[20]王迅,郑岚,张晰,等.核酸扩增技术(NAT)在上海血液筛检中的初步应用[J].中国输血杂志,2003,16(3):157-160.
[21]刘江.对北京地区三种血源的检验分析[J].中华医院管理杂志,1999,15(8):487-493.
[2]国杰,张婷,桂萍,等.北京某医院2012-2016年无偿献血者血液感染性指标检测结果分析[J].标记免疫分析与临床,2017,24(9):967-972.
[3]卫生部血液标准专业委员会.血液筛查丙氨酸氨基转移酶临界值变更专题研讨会纪要[EB/OL].(2013-05-23)[2014-01-14]. http://www. jsblood. com. cn/artiele. php? id=2386.
[4]张研,文国新,刘金保.自愿无偿献血者ALT升高与非病理影响因素的相关性研究[J].中国输血杂志,2013,26(2):156-158.
[5] ALTERH J. Transmitted hepatitis C and non-A non-B NON-C[J].Vox Sang,1994,67(3):19-24
[6] KLEIN H G. Controversies in transfusion medicine ALT screening of blood donors[J]. Pro Transfusion, 1990,30(4):363.
[7]邬旭群.无偿献血者丙氨酸氨基转移酶检测的意义[J].广东医学.2002,23(8):840-841.
[8] BRINKMANN T, DREIER J, DIEKMANN J, et al. Alanine aminotransferase cut-off values for blood dinor screening using the new International Federation of Clinical Chemistry reference method at 37 degrees C[J].Vox Sanguins, 2003,85(3):159-164.
[9]桂萍,张婷,乔木,等.丙氨酸氨基转移酶的临界值改变对献血者血液筛查的影响[J].临床输血与检验,2015, 17(5):466-467.
[10]刘玉振,邢培清,李伍升,等.无偿献血人群中ALT、抗-HCV和HBsAg阳性模式分布调查[J].解放军预防医学杂志,2004,22(4):278-279.
[11]王瑞,黄力勤,张婧,等.实施核酸检测后重新评估献血者ALT的检测功效[J].中国输血杂志,2017,30(9):1034-1038.
[12]梁晓峰,陈园生,王晓军.中国3岁以上人群乙型肝炎血清流行病学研究[J].中华流行病学杂志,2005,26(9):655-658.
[13] BATES I,MANYASI G,LARAA M. Reducing replacement donors in Sub-Saharan Africa:challenges and affordability[J]. Transfus Med,2007,17(6):434-442.
[14] BIANCO C. Difficult blood donor choices:dance, feast or donate blood?[J].Rev Bras Hematol Hemoter,2013,35(4):225-241.
[15]朱燕霞,钱宝华,查占山,等.流动采血车无偿献血血液情况分析[J].中国输血杂志,2008,21(2):126-127.
[16]丁左红,蔡莉.成分献血者体检、初筛不合格原因分析[J].临床输血与检验,2015,17(5):461-462.
[17]王迅.采供血机构开展血液病毒核酸检测的条件及意义[J].中国输血杂志,2008,21(11):825-826.
[18]刘胡敏,陈传敏,高加良,等.ELISA结合核酸检测技术对献血者血液筛查结果分析[J].中国输血杂志,2013,26(5):456-457.
[19] BUSCH M P. HIV, HBV, and HCV:new developments related to transfusion safety[J]. Vox Sang,2000,78(suppl2):253-256.
[20]王迅,郑岚,张晰,等.核酸扩增技术(NAT)在上海血液筛检中的初步应用[J].中国输血杂志,2003,16(3):157-160.
[21]刘江.对北京地区三种血源的检验分析[J].中华医院管理杂志,1999,15(8):487-493.