献血者梅毒血清学流行趋势、危险因素与高危人群献血现状  

Analysis of the current situation on syphilis' serological epidemic trends,risk factors,and high-risk population's donation status

作　　者：刘双丽[1] 席光湘[1] 钟利[1] 陈雪[1] 张蓝江[1] 罗利平[2] 万浬科[1] 李书平[1] 赵颖[1] 廖耘[1] 何毅[1] 

机构地区：[1]成都市血液中心,四川成都610041 [2]宜宾市中心血站

出　　处：《中国输血杂志》2014年第11期1133-1137,共5页Chinese Journal of Blood Transfusion

基　　金：四川省卫生厅科研项目(050169);成都市卫生局年重大科技攻关课题(0951)

摘　　要：目的通过对献血者感染梅毒的流行趋势、危险因素及高危人群通过健康征询进入献血流程的研究,探讨强化血液安全的相关策略。方法对2005-2013年成都地区自愿无偿献血者抗-TP检测结果进行梅毒血清学流行趋势分析。还选择2011年11月-2012年3月抗-TP阳性的献血者204名及血液筛查项目阴性献血者408名进行病例对照研究,应用条件Logistic回归模型分析与感染梅毒有关的因素,并对危险行为的人群归因危险度（PAR）进行估计。结果2005-2013年9年间成都地区献血者梅毒血清学流行率总体呈上升趋势。纳入对象阳性组中49.5%献血者有多性伴,11.8%有有偿性行为;阴性组16.7%有多性伴,3.2%具有有偿性行为的献血者通过了献血前筛查程序。筛选出与梅毒感染有关的危险因素：多性伴、美容手术史、梅毒性接触史,不确定是否有梅毒性接触史,其危险度为（OR值）分别为：2.580、1.642、2.189、2.471,95%CI分别是：1.517-4.387、1.236-2.183、1.250-3.833、1.719-3.553。人群归因危险度分别是：0.169、0.105、0.013、0.048,综合人群归因危险度是33.5%。结论目前献血前健康征询对高危人群的筛除工作需要改善,献血者招募工作应该重视排除高危献血者和招募更多的低危献血者。Objective To investigate the serological epidemic trends and the risk factors of syphilis among blood donors,to study the donation status of high-risk population through health consultations,and to explore effective strategies to enhance blood safety. Methods Serological test results of volunteer blood donors were collected from Chengdu Blood Center during2005 and 2013. A retrospective study was conducted on 204 TP positive blood donors and 408 TP negative blood donors. Conditional logistic regression models were performed to investigate syphilis-related risk factors and population attributable risk（ PAR） was performed to predict high-risk populations＇ tendencies on risky behaviors. Results The serological epidemic for syphilis among blood donors in Chengdu showed an upward trend from 2005 to 2013. Compared with blood donors with TP negative,TP positive blood donors were more likely to have multiple sexual partners and commercial sex（ 49. 5% vs. 16. 7%;11. 8% vs. 3. 2%）. Multiple condition logistic regression model denoted the following risk factors for increasing rates of syphilis infections： multiple sexual partners（ OR = 2. 580; 95% CI = 1. 517,4. 387）,cosmetic surgery（ OR = 1. 642; 95% CI =1. 236,2. 183）,sexual contact with syphilis patients（ OR = 2. 189; 95% CI = 1. 250,3. 833）,unaware of sexual involvement with syphilis patients（ OR = 2. 471; 95% CI = 1. 719,3. 553）. The PAR for each of the risk factors were 0. 169、0. 105、0. 013、0. 048,respectively. The total PAR was 33. 5%. Conclusion Health consultation and screening of high-risk groups before blood donation show room for improvement. Blood donor recruitment should emphasize on excluding the high-risk donors and recruiting more low-risk blood donors.

关 键 词：高危人群 健康征询 血液安全 梅毒 危险因素 献血者 

分 类 号：R193.3[医药卫生—卫生事业管理] R457.12[医药卫生—公共卫生与预防医学]