深圳地区献血者丙氨酸氨基转移酶检测结果分析及阈值调整策略的探讨  

Alanine transferase test results and exploration of threshold adjustment strategies for blood donors in Shenzhen,China

作　　者：郑欣[1] 薛原野 王皓飚 伍立桃 李然 党英男 陈婷婷 许晓绚[1] 曾雪珍[1] 曾劲峰[1] ZHENG Xin;XUE Yuanye;WANG Haobiao;WU Litiao;LI Ran;DANG Yingnan;CHEN Tingting;XU Xiaoxuan;ZENG Xuezhen;ZENG Jinfeng(Shenzhen Blood Center,Shenzhen 518172,China;Qinghai Provincial Blood Center,Xining 810000,China)

机构地区：[1]深圳市血液中心,广东深圳518000 [2]青海省血液中心,青海西宁810000

出　　处：《中国输血杂志》2025年第4期488-494,共7页Chinese Journal of Blood Transfusion

基　　金：深圳市医疗卫生三名工程(SZSM202311032)。

摘　　要：目的通过回顾性统计对比献血者采血前丙氨酸氨基转移酶(ALT)检测值,分析献血者ALT不合格(ALT>50 U/L)的人群客观特征,为ALT筛查合格阈值调整提供参考数据。方法抽取深圳市血液中心2022—2023年度3个智慧捐血点的30341人次献血者献血前ALT初筛数据,与之对比的数据来自深圳地区某三甲医院体检科(即普通人群,n=24906),两者进行分类统计描述。回顾性分析了献血者的性别、年龄、民族,及捐血点、献血季节、献血次数等因素与ALT检测结果的关系。结果献血者与普通人群2组人群的ALT为非正态分布,献血者和普通人群的ALT检测值的95%百分位数分别是61.4 U/L(男性67.8U/L、女性39.3 U/L)和58.1 U/L(男性63.7 U/L、女性51.2 U/L)。2组人群ALT>50 U/L的不合格率分别是7.65%(2321/30341)和7.08%(1763/24906)。献血者中,ALT不合格率在性别、年龄、捐献点上有显著性差异(P<0.05),在献血季节上无显著差异(P>0.05)。ALT不合格者和合格者的血筛病原体四项(HBsAg、抗-HCV、HIV Ag/Ab、抗-TP)血清学标志物阳性率(2.05%vs 1.5%)无统计学显著差异(P>0.05)。如果把ALT合格阈值由50 U/L上调至90 U/L,男性和女性献血者不合格率分别从9.82%(2074/21125)下降至2.23%(471/21125)以及从2.70%(249/9216)下降至0.75%(69/9216)。献血3次以上的154名献血者的248次ALT不合格的检测数值有88.31%在50~90 U/L范围,其中9例ALT>130 U/L者,在后续的献血中ALT均转为合格。结论不同性别、年龄的献血者ALT不合格率有差异,不同献血点位及操作者也会影响献血者ALT检测值;献血者ALT不合格绝大多数为短暂性且非病理性因素引起,在血液病毒核酸普遍开展情况下,适当提高献血者ALT合格阈值可扩大献血者合格人群,缓解血源紧张状况,且血液安全风险不会升高。Objective To conduct a retrospective statistical comparison of alanine aminotransferase(ALT)test values in blood donors prior to blood collection,aiming to analyze the objective characteristics of the population with elevated ALT levels(ALT>50 U/L)and provide reference data for adjusting the screening eligibility threshold for ALT.Methods The preliminary ALT screening data of 30341 blood donor samples collected prior to blood donation from three smart blood donation sites at the Shenzhen Blood Center between 2022 and 2023 were extracted and compared with data from a health examination department of a tertiary hospital in Shenzhen(representing the general population,n=24906).Both datasets were categorized and statistically described.A retrospective analysis was conducted to examine the associations between ALT test results and factors such as donors′gender,age,ethnicity,donation site,donation season,and frequency of blood donation.Results The ALT levels in both blood donors and the general population were non-normally distributed.The 95th percentile of ALT values was calculated as 61.4 U/L(male:67.8 U/L,female:39.3 U/L)for blood donors and 58.1 U/L(male:63.7 U/L,female:51.2 U/L)for the general population.The non-compliance rates(ALT>50 U/L)were 7.65%(2321/30341)in blood donors and 7.08%(1763/24906)in the general population.There were significant differences(P<0.05)in the ALT failure rate among blood donors based on gender,age,and donation site,but no significant differences(P>0.05)during the blood donation season.There was no statistically significant difference(P>0.05)in the positive rates of four serological markers(HBsAg,anti HCV,HIV Ag/Ab,anti TP)for blood screening pathogens between ALT unqualified and qualified individuals(2.05%vs 1.5%).If the ALT qualification threshold was raised from 50 U/L to 90 U/L,the non qualification rates of male and female blood donors would decrease from 9.82%(2074/21125)to 2.23%(471/21125)and from 2.70%(249/9216)to 0.75%(69/9216),respectively.Among the 154 blood donors who dona

关 键 词：无偿献血者 丙氨酸氨基转移酶 血液筛查 差异对比 分析 

分 类 号：R457.1[医药卫生—治疗学] R446.6[医药卫生—临床医学]