高海拔地区献血者红细胞增多症患病比例及其影响因素的调查分析  

Investigation on the prevalence rate and influence factors of high altitude polycythemia among blood donors in high altitude area

作　　者：王瑛[1] 张玉华[1] 赵敬湘[1] 李鹏龙[1] 刘佳[2] 赵莲[1] 周虹[1] 

机构地区：[1]军事医学科学院野战输血研究所,北京100850 [2]军事医学科学院附属医院

出　　处：《中国输血杂志》2017年第3期296-299,共4页Chinese Journal of Blood Transfusion

摘　　要：目的了解高原献血人群中高原红细胞增多症(HAPC)发病情况及其影响因素。方法收集2015年5-7月在海拔3 000-4 000 m地方献血的289名献血者基本信息、既往病史、体格检查等资料,获得其HAPC患病比例,采用t检验、Wilcoxon秩和检验及Logistic回归等统计方法做单因素或(和)多因素分析。结果收缩压(mm Hg),有、无HAPC的献血者为115.42±14.38vs 121.56±8.42(P<0.01);汉族、藏族与其他少数民族献血者中患HAPC的比例为64.89%(170/262)vs 62.50%(5/8)vs 21.05%(4/19)(P<0.01);从事脑力劳动、不吸烟的献血者患HAPC的比例为81.08%(30/37)、73.25%(178/243),高于体力劳动者和吸烟者(P<0.05);献血者ABO血型中,A、B、O和AB型者患HAPC的比例为45.21%(33/73)vs 63.33%(57/90)vs 69.31%(70/101)vs 70.00%(14/20)(P<0.01)。此外,除单因素分析获得的收缩压、民族、工作性质、吸烟及血型外,经多因素分析显示:年龄(OR=1.333)、舒张压(OR=1.377)、脉搏(OR=1.161)等在HAPC的发生中也有一定影响。结论年龄、民族、工作性质、吸烟、血压、脉搏、ABO血型可能为诱发HAPC的因素,高原采血尤其是应急采血需关注献血者相关资料及参数变化。Objective To study the prevalence rate and influence factor of the high altitude polycythemia （HAPC） among blood donors in high altitude area.Methods The essential information,previous medical history and physical assessment data of 289 blood donors who donated blood at the altitude of 3 000-4 000 m from May to July in 2015 were collected.The prevalence ratio of HAPC was obtained.T-test,Wilcoxon rank-sum test and Logistic regression were used respectively to carry out single factor analysis and/or multiple-factor analysis.Results The systolic pressure of the non-HAPC patients was （121.56±8.42） mmHg,which was significantly higher than that of HAPC patients [（115.42± 14.38） mmHg,P〈0.01].The prevalence ratios of HAPC in Han nationality,Zang nationality and other minorities were 64.89% （170/262） vs 62.50% （5/8） vs 21.05% （4/19）,respectively （P〈0.01）.The prevalence ratios of HAPC in mental workers and nonsmokers were 81.08% （30/37）,73.25% （178/243）,which were higher than that in manual workers and smokers （P〈0.05）.The prevalence ratios of HAPC in people who were A type,B type,O type or AB type were 45.21% （33/73） vs 63.33% （57/90） vs 69.31% （70/101） vs 70.00% （14/20）,respectively （P〈0.01）.Moreover,in addition to the systolic pressure,ethnicity,job,smoking history and blood type,age （OR=1.333）,diastolic pressure （OR=1.377） and pulse （OR=1.161） were also considered the major factors of HAPC,which were shown by multiple-factor analysis.Conclusion The age,ethnieity,job,smoking history,pressure,pulse and blood type play the key roles in the morbidity of HAPC.Theses related information of the blood donors should be closely monitored in the emergency blood collection in the high altitude area.

关 键 词：高原红细胞增多症 HAPC影响因素 高原献血者 民族 血压 血型 高原采血 

分 类 号：R555.1[医药卫生—血液循环系统疾病] R193.3[医药卫生—内科学]