我国献血相关血管迷走神经反应发生率的系统评价与Meta分析  

Prevalence of blood donation related vasovagal reactions in China:a systematic review and Meta-analysis

作　　者：肖光林 周巧灵 王娅[1] 赵沛喆 卢丽[1] 李婉 XIAO Guanglin;ZHOU Qiaoling;WANG Ya;ZHAO Peizhe;LU Li;LI Wan(Institute of Blood Transfusion,Chinese Academy of Medical Sciences&Peking Union Medical College,Chengdu 610052,China;Department of Infectious Diseases,Sichuan Academy of Medical Sciences,Sichuan Provincial People's Hospital)

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]四川省医学科学院·四川省人民医院感染科

出　　处：《中国输血杂志》2022年第11期1139-1144,共6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重大协同创新项目-血液安全预警体系构建及干预研究(2022)(2021-I2M-1-060-2022-W0)。

摘　　要：目的通过Meta分析系统评价献血相关血管迷走神经反应(donation related vasovagal reaction,DRVR)在国内的发生率,并探讨DRVR的风险因素,为开展DRVR相关预防与控制工作提供科学依据。方法计算机检索Cochrane Library、PubMed、WanFang Data和CNKI等相关数据库,搜集有关我国全血捐献DRVR发生率及危险因素的研究,发表时间为1998~2020年。由2位研究人员按照纳入与排除标准独立筛选文献、提取资料和评价纳入文献质量后,采用Stata软件进行Meta分析。结果共纳入了63项研究,涉及6043945名献血者。DRVR的发生率为1.0%[95%可信区间(CI),0.9~1.1,I~2=99.7%,P<0.01]。女性DRVR发生率(1.4%,95%CI:1.0~1.8,I~2=99.6%,P<0.01)高于男性(1.1%,95%CI:0.8~1.4,I~2=99.6%,P<0.01)。年龄方面,18~25岁献血者DRVR发生率为1.3%(95%CI:0.8~1.8,I~2=97.9%,P<0.01),26~35岁为0.8%(95%CI:0.5~1.0,I~2=95.0%,P<0.01),36~45岁为0.4%(95%CI:0.3~0.5,I~2=88.5%,P<0.01),46~55岁为0.3%(95%CI:0.1~0.6,I~2=96.1%,P<0.01),随着年龄的增加,DRVR发生率降低。1998~2020年间,DRVR发生率逐年降低(P<0.01)。首次献血者DRVR发生率(1.5%,95%CI:1.3~1.8,I~2=98.6%,P<0.01)高于重复献血者(0.6%,95%CI:0.5~0.7,I~2=97.2%,P<0.01)。焦虑是引起DRVR最主要的危险因素。结论采供血机构应加强对DRVR的监测,应更加重视年轻女性,关注首次献血者,并制定更加完善的献血政策,以减少DRVR的发生。Objective To systematically evaluate the incidence of donation related vasovagal reactions(DRVR)in China by Meta-analysis method and discuss the risk factors of DRVR,so as to provide scientific basis for the prevention and control of DRVR.Methods Cochrane Library,PubMed,WanFang Data CNKI and other electronic databases were retrieved to collect research literature concerning the incidence and risk factors of DRVR among whole blood donors in China's Mainland,with the publishing duration setting from 1998 to 2020.Two reviewers independently screened the literature,extracted the data,and evaluated the methodological quality of the included studies according to the inclusion and exclusion criteria.Then Stata was used for Meta-analysis.Results A total of 63 studies involving 6043945 donors were included.The prevalence of DRVR was 1.0%(95%confidence interval[CI],0.9%~1.1%,I~2=99.7%,P<0.01).The prevalence of DRVR in females(1.4%,95%CI:1.0-1.8%,I~2=99.6%,P<0.01)was higher than that in males(1.1%,95%CI:0.8-1.4%,I~2=99.6%,P<0.01).The incidence of DRVR was 1.3%(95%CI:0.8-1.8,I~2=97.9%,P<0.01),0.8%(95%CI:0.5-1.0,I~2=95.0%,P<0.01),0.4%(95%CI:0.3-0.5,I~2=88.5%,P<0.01)and 0.3%(95%CI:0.1-0.6,I~2=96.1%,P<0.01)in the age groups of 18-25,26-35,36-45 and 46-55,respectively,and the incidence of DRVR decreased with age(P<0.01).From 1998 to 2020,the incidence of DRVR decreased year by year(P<0.01).The prevalence in first-time donors(1.5%,95%CI:1.3-1.8,I~2=98.6%,P<0.01)was higher than that of regular donors(0.6%,95%CI:0.5-0.7%,I~2=97.2%,P<0.01).Anxiety was the major risk factor for DRVR.Conclusion Our results indicate that blood centers should strengthen the monitoring of DRVR.More attention should be paid to young women,more comfort given to first-time blood donors,and a more perfect system developed to reduce the occurrence of DRVR.

关 键 词：献血相关血管迷走神经反应 全血捐献 发生率 系统评价 META分析 

分 类 号：R457.1[医药卫生—治疗学]