献血者人细小病毒B19感染的Meta分析  

Human parvovirus B19 infection in blood donors: a meta-analysis

作　　者：王志效 周贝贝[1] 张娜[1] 黄海燕[1] WANG Zhixiao;ZHOU Beibei;ZHANG Na;HUANG Haiyan(Jining Blood Center,Jining 212011,China)

机构地区：[1]济宁市中心血站,山东济宁272011

出　　处：《中国输血杂志》2022年第2期171-175,共5页Chinese Journal of Blood Transfusion

摘　　要：目的分析我国不同地区献血者人细小病毒B19感染现状,为各城市和地区制定合理的献血者B19病毒筛查方案提供依据。方法数据库检索1998~2021年公开发表的全血及血浆献血者人细小病毒B19感染相关的文献,运用R4.1.0软件将符合纳入标准的文献进行Meta分析。结果获得符合标准的文献共35篇,20篇文献共计调查56 846份献血者标本并做B19 DNA阳性率Meta分析,8篇文献共计调查1 608份混合原料血浆标本并做B19 DNA阳性率Meta分析,17篇文献共计调查12 308份献血者标本并做B19 IgG抗体阳性率Meta分析。献血者B19 DNA阳性率(I^(2)=96%,τ^(2)=0.0260,P<0.01),混合原料血浆中B19 DNA阳性率(I^(2)=98%,τ^(2)=0.1245,P<0.01),B19 IgG抗体阳性率(I^(2)=98%,τ^(2)=0.0210,P<0.01),在各地区标本之间存在显著异质性,故采用随机效应模型估计B19 DNA合并阳性率为2.0%(95%CI:0.007~0.039),生产用混合血浆制品B19 DNA合并阳性率为66.6%(95%CI:0.476~0.832),B19 IgG抗体合并阳性率为30.2%(95%CI:0.246~0.357)。结论 HPV B19在献血者中的感染率较低,IgG抗体阳性率较高,故因输血感染B19病毒的风险较低,但献血者B19感染存在较大的地区差异性,我国各城市和地区应合理评估本地区的B19病毒感染水平,结合地区流行病学调查情况,制定适宜的献血者B19病毒筛查方案,以降低输血传播B19病毒的风险。此外,B19病毒在生产用混合血浆制品中的感染率较高,对血浆制品生产企业来源的血液制品的受血者应进行B19病毒抗体筛查,并对中和性B19 IgG抗体缺乏的受血者制定适宜的血液制品输注方案,以降低因输血感染B19病毒的风险。Objective To analyze the current situation of human parvovirus B19 infection in blood donors in different regions of China, so as to provide basis for formulating reasonable screening programs of B19 virus for blood donors in various cities and regions. Methods The literatures related to human parvovirus B19 infection in whole blood and plasma donors published from 1998 to 2021 were searched in the database, and meta-analysis of literatures that satisfied the inclusion criteria was conducted by R4.1.0 software. Results A total of 35 literatures were obtained, 20 literatures involving 56 846 blood donor samples and 8 literatures involving 1 608 pooled raw plasma samples were subjected to Meta analysis of the positive rates of B19 DNA;17 literatures involving 12 308 blood sample were subjected to the Meta analysis of the positive rate of B19 IgG antibody.The positive rates of B19 DNA in blood donors(I^(2)=96%,τ^(2)=0.026 0,P<0.01)and pooled raw plasma(I^(2)=98%,τ^(2)=0.124 5,P<0.01), as well as the positive rate of B19 IgG antibod(I^(2)=98%, τ^(2)=0.021 0, P < 0.01) presented significant heterogeneity between regions. The combined positive rate of B19 DNA was estimated to be 2.0%(95%-CI:0.007~0.039), that of pooled raw plasma for production was 66.6%(95%-CI:0.476~0.832), and that of B19 IgG antibody was 30.2%(95%-CI:0.246~0.357). Conclusion Low HPV B19 infection rate and high positive rate of IgG antibody were found in blood donors. Therefore, the risk of B19 virus infection due to blood transfusion is low, but B19 infections in blood donors varied significantly between regions. Domestic cities and regions should reasonably evaluate their own B19 virus infection status to formulate appropriate B19 virus screening programs for blood donors, so as to reduce blood transfusion transmitted risk of B19 virus. In addition, the infection rate of B19 virus in pooled plasma for production is somewhat high. Recipients should be screened for B19 virus antibodies, and appropriate blood transfusion schemes should be formulate

关 键 词：献血者 人细小病毒B19 META分析 输血安全 

分 类 号：R457.1[医药卫生—治疗学] R373[医药卫生—临床医学]