献浆相关血管迷走神经反应风险因素分析  

Risk factor analysis of plasma donation related vasovagal reaction

作　　者：赵沛喆 李玲[1,2] 董德梅 巫彩霞 官笑羽 周亚玲 武云香 冯国强 李彦玉 张德梅 刘忠 ZHAO Peizhe;LI Ling;DONG Demei;WU Caixia;GUAN Xiaoyu;ZHOU Yaling;WU Xiangyun;FENG Guoqiang;LI Yanyu;ZHANG Demei;LIU Zhong(Institute of Blood Transfusion,Chinese Academy of Medical Sciences&Peking Union Medical College,Chengdu 610052,China;Key Laboratory of Transfusion Adverse Reactions,CAMS;Shanxi Blood Center;不详)

机构地区：[1]中国医学科学院北京协和医学院输血研究所,四川成都610052 [2]中国医学科学院输血不良反应研究重点实验室 [3]山西省血液中心 [4]北京天坛生物制品股份有限公司

出　　处：《中国输血杂志》2022年第6期629-632,共4页Chinese Journal of Blood Transfusion

基　　金：中国医学科学院医学与健康科技创新工程(2021-1-I2M-060);四川省国际科技创新合作/港澳台科技创新合作项目(2020YFH0024)。

摘　　要：目的探讨献浆相关血管迷走神经反应(VVR)发生的风险因素,以此提出临床建议,实现对高危人群的早期识别、精准干预,保障献浆安全。方法采集2019年7~12月四川某地区献浆人群人口学特征(性别、年龄、体重)及献浆记录(献浆史、献浆前脉搏、采集持续时间等),基于logistic回归分析,探究这些因素与VVR发生风险的相关性。结果本研究共采集69172例献浆者信息,VVR发生率为7.04‰。血浆采集持续时间<30 min组与>50 min组相比,发生VVR的风险可降低99%(OR=0.01;95%CI,0.00~0.01;P<0.001);男性组与女性组相比发生风险可降低94%(OR=0.06;95%CI,0.04~0.10;P<0.001);体重大于80 kg组与45~50 kg组相比发生风险可降低80%(OR=0.20;95%CI,0.09~0.42;P<0.001),重复献浆组与首次献浆组相比发生风险可降低34%(OR=0.66;95%CI,0.47~0.91;P<0.05);献浆前脉搏大于90 bpm组的VVR发生风险是60~69bmp组的2.43倍(OR=2.43;95%CI,1.75~3.36;P<0.001)。结论血浆采集持续时间、性别、体重、献浆次数、献浆前脉搏以及献浆史为献浆相关VVR的独立风险因素。其中,血浆采集持续时间、性别和体重是献浆相关VVR主要的独立风险因素。采集时长大于50 min,女性献浆者,体重较小者发生VVR的风险较高,应给予更多预防性干预。Objective To investigate the risk factors of vasovagal reactions(VVR)related to plasma donation,so as to put forward clinical suggestions for early identification and accurate intervention of high-risk groups to ensure the safety of plasma donation.Methods The demographic characteristics(i.e.gender,age,weight)and records of plasma donors(donation history,pulse before plasma donation,duration of collection,etc.)were collected from July to December 2019 in a region of Sichuan.Based on logistic regression analysis,the correlation between these factors and the risk of VVR was explored.Results The information of 69172 donors was collected,and the incidence of VVR was 7.04‰.The risk of VVR was reduced by 99%in the group with plasma collection duration less than 30 minutes compared with the group with plasma collection duration more than 50 minutes(OR,0.01;95%CI,0.00~0.01;P<0.001).The risk of male group was 94%lower than that of female group(OR,0.06;95%CI,0.04~0.10;P<0.001).Compared with the 45~50 kg group,the risk of weight greater than 80 kg group decreased by 80%(OR,0.20;95%CI,0.09~0.42;P<0.001).The risk of repeated donation group was 34%lower than that of the first time donation group(OR,0.66;95%CI,0.47~0.91;P<0.001).The risk of VVR in the group with pulse greater than 90 bpm before plasma donation was 2.43 times that in the 60~69 bmp group(OR,2.43;95%CI,1.75~3.36;P<0.001).Conclusion Duration of plasma collection,gender,weight,frequency of plasma donation,pulse before plasma donation and donor status are independent risk factors for plasma donation-related VVR.Among them,plasma collection duration,gender and weight were the main independent risk factors for plasma donation-related VVR.For donors with plasma collection duration more than 50 minutes,female and low weight,higher risk of VVR was presented and more preventive intervention should be given.

关 键 词：献浆不良反应 血管迷走神经反应 风险因素 LOGISTIC回归 

分 类 号：R193.3[医药卫生—卫生事业管理] R331.32[医药卫生—公共卫生与预防医学] Q429.92[生物学—神经生物学]