CAJ | 학술논문

目的探讨在人类免疫缺陷病毒(HIV)流行新形势下,志愿无偿献血模式的安全性.方法选择2008年1月至2012年12月于深圳市采供血机构献血的438 123例志愿无偿献血者作为研究对象.根据《献血者健康检查要求》(GB 18467-2011)对献血者分类的定义,将无偿献血者分为3组:固定献血组(n=87 460),不定期献血组(n=67 812)和初次献血组(n=282 851).血液HIV初筛检测采用酶联免疫吸附法测定,反应性标本采用Western免疫印迹法确认.分析比较2008-2012年深圳市不同类型志愿无偿献血者HIV感染分布情况及变化趋势.结果 2008-2012年深圳市采供血机构固定献血组人群的HIV感染率分别为0.0/10万、0.0/10万、17.1/10万、10.5/10万、9.8/10万,HIV总感染率为8.0/10万,总体处于平稳的低流行状态(x2=1.664,P＞0.05);不定期献血组人群的HIV感染率分别为25.0/10万、32.1/10万、60.0/10万、69.6/10万、57.4/10万,HIV总感染率为50.1/10万,处于平稳的较高流行状态(x2=2.606,P＞0.05);初次献血组人群的HIV感染率分别为15.6/10万、14.3/10万、42.3/10万、62.7/10万、67.4/10万,HIV总感染率为42.8/10万,于2010年起呈逐年增长趋势(x2=30.327,P＜0.01).不定期献血组HIV感染率最高(50.1/10万),其次为初次献血组(42.8/10万),但两组相比,差异无统计学意义(x2=0.67,P＞0.05).固定献血组HIV感染率最低(8.0/10万),与不定期献血组、初次献血组分别相比,差异均有统计学意义(x2 =25.69,23.38;P＜0.01).结论深圳市志愿无偿献血人群HIV感染流行趋势呈现出新的态势,仅通过提高固定志愿无偿献血队伍的数量已不能充分保障血液安全.应采用高灵敏度的核酸检测、系统性地加强志愿无偿献血者的健康教育、高度重视献血者健康评估和重视招募集体献血人群等手段进一步保障血液安全.
목적 탐토재인류면역결함병독(HIV)류행신형세하,지원무상헌혈모식적안전성.방법 선택2008년1월지2012년12월우심수시채공혈궤구헌혈적438 123례지원무상헌혈자작위연구대상.근거《헌혈자건강검사요구》(GB 18467-2011)대헌혈자분류적정의,장무상헌혈자분위3조:고정헌혈조(n=87 460),불정기헌혈조(n=67 812)화초차헌혈조(n=282 851).혈액HIV초사검측채용매련면역흡부법측정,반응성표본채용Western면역인적법학인.분석비교2008-2012년심수시불동류형지원무상헌혈자HIV감염분포정황급변화추세.결과 2008-2012년심수시채공혈궤구고정헌혈조인군적HIV감염솔분별위0.0/10만、0.0/10만、17.1/10만、10.5/10만、9.8/10만,HIV총감염솔위8.0/10만,총체처우평은적저류행상태(x2=1.664,P＞0.05);불정기헌혈조인군적HIV감염솔분별위25.0/10만、32.1/10만、60.0/10만、69.6/10만、57.4/10만,HIV총감염솔위50.1/10만,처우평은적교고류행상태(x2=2.606,P＞0.05);초차헌혈조인군적HIV감염솔분별위15.6/10만、14.3/10만、42.3/10만、62.7/10만、67.4/10만,HIV총감염솔위42.8/10만,우2010년기정축년증장추세(x2=30.327,P＜0.01).불정기헌혈조HIV감염솔최고(50.1/10만),기차위초차헌혈조(42.8/10만),단량조상비,차이무통계학의의(x2=0.67,P＞0.05).고정헌혈조HIV감염솔최저(8.0/10만),여불정기헌혈조、초차헌혈조분별상비,차이균유통계학의의(x2 =25.69,23.38;P＜0.01).결론 심수시지원무상헌혈인군HIV감염류행추세정현출신적태세,부통과제고고정지원무상헌혈대오적수량이불능충분보장혈액안전.응채용고령민도적핵산검측、계통성지가강지원무상헌혈자적건강교육、고도중시헌혈자건강평고화중시초모집체헌혈인군등수단진일보보장혈액안전.
Objective To explore suitable strategy for blood donation safety under human immunodeficiency virus (HIV) infection new situation.Methods From January 2008 to December 2012,a total of 438 123 voluntary unpaid blood donors in Shenzhen Blood Station were included in this study.According to the definition of classification of blood donors in Whole blood and component donor selection requirements (GB 18467-2011),all the donors were classified into 3 groups:regular voluntary blood donors group (n =87 460),unfixed voluntary blood donors group (n =67 812),and primary voluntary blood donors group (n=282 851).Their blood samples were screened by enzyme-linked immunosorbent assay (ELISA) test and confirmed by Western blotting (WB) test.The distribution and variation trend of their HIV infection rates were analyzed and compared.Results The HIV infection rates of regular voluntary blood donors group from 2008 to 2012 were 0.0,0.0,17.1,10.5 and 9.8 per 100 000,respectively.Total HIV infection rate was 8.0 per 100 000.Regular voluntary blood donors were in a stable state of low prevalence (x2 =1.664,P＞0.05).HIV infection rates of unfixed voluntary blood donors group were 25.0,32.1,60.0,69.6 and 57.4 per 100 000,respectively.The total rate was 50.1 per 100 000.Unfixed voluntary blood donors were in a stable state of high prevalence (x2 =2.606,P＞0.05).HIV infection rates of primary voluntary blood donors group were 15.6,14.3,42.3,62.7 and 67.4 per 100 000,respectively.The total rate was 42.8 per 100 000.HIV infection trends of primary voluntary blood donors was stable and low before 2009,but gradually increased from 2010(x2=30.327,P＜0.01).HIV infection rates of unfixed voluntary blood donors group was the highest (50.1 per 100 000),then HIV infection rates of primary voluntary blood donors group was the second highest (42.8 per 100 000) among these three group.But,there was no statistical difference between them (x2 =0.67,P＞ 0.05).HIV infection rate of regular voluntary blood donors group was significantly lower than unfixed blood donors group or primary blood donors group(x2 =25.69,23.38,P ＜0.01).Conclusions Under the new HIV infection situation of Shenzhen blood donors,that it has not been ensured blood safety by increasing the number of regular voluntary blood donors.Many methods should be accepted for blood safety,for example,using nucleic acid test (NAT) with high sensitivity,strengthening health education of donors,attaching importance to health assessment and recruitment of collective blood donors.