冷刺激干预对减少献血反应、一过性丙氨酸氨基转移酶轻度升高的作用研究

摘要

Objective To explore the role of cold stimulation intervention in reducing blood donation reaction and transient moderately elevated ALT. Methods From October 2003 to October 2013 in the Central Blood Station of Handan,a total of 2 352 voluntary blood donors with blood donation reaction,delayed blood donation reaction or first occurrence of blood donation reaction before blood donation were found,and 200 cases were selected to enroll this study,they were divided into control group and intervention group according to whether received cold stimulation intervention or not,each of 100 cases;a total of 300 voluntary blood donors with transient moderately elevated ALT were selected as observation group. Voluntary blood donors of control group received conventional treatment,while voluntary blood donors of intervention group and observation group received cold stimulation intervention. Incidence of sufficient quantity of blood donation volume,blood donation reaction weakened or disappeared,blood donation reaction - induced psychological impact and physical impact were compared between control group and intervention group,incidence of delayed blood donation reaction of voluntary blood donors with positive history of delayed blood donation reaction was observed;pass percent of ALT and ALT level of observation group were recorded at the first,second and third detection of ALT. Results The incidence of sufficient quantity of blood donation volume,blood donation reaction weakened or disappeared,blood donation reaction - induced psychological impact of intervention group was statistically significantly lower than that of control group( P ﹤ 0. 05),while no statistically significant differences of incidence of blood donation reaction - induced physical impact was found between control group and intervention group(P ﹥ 0. 05). Of intervention group,no one of the 3 cases with positive history of delayed blood donation reaction occurred delayed blood donation reaction;of control group,all of the 3 cases with positive history of delayed blood donation reaction occurred delayed blood donation reaction. At the first detection of ALT,the pass percent was 0,the mean level was(49 ± 5) U/ L;at the second detection of ALT,the pass percent was 32. 7% (98 / 300),the mean level was(43 ± 6) U/ L;at the third detection of ALT,the pass percent was 86. 7% (85 / 98),the mean level was(35 ± 4) U/ L. Conclusion Cold stimulation intervention is safe and feasible,play an important role in reducing blood donation reaction,delayed blood donation reaction and transient moderately elevated ALT,is helpful to relieve the severity of blood donation reaction and to improve the pass percent of ALT.%目的：探讨冷刺激干预对减少献血反应、一过性丙氨酸氨基转移酶（ALT）轻度升高的作用。方法2003年10月—2013年10月，邯郸市中心血站共发现2352例无偿献血者出现献血反应、迟发性献血反应或为初次献血在献血前出现献血反应，选取其中有献血反应史、迟发性献血反应史或为初次献血但在献血前出现献血反应的无偿献血者200例，根据冷刺激干预情况分为干预组和对照组，各100例；另选取同期出现一过性 ALT 轻度升高的无偿献血者300例作为观察组。对照组无偿献血者进行常规处理，干预组和观察组无偿献血者进行冷刺激干预。比较干预组和对照组无偿献血者献血量足量情况、献血反应减弱或消失情况、献血反应对心理及身体造成影响的发生情况，观察干预组和对照组有迟发性献血反应史者迟发性献血反应发生情况及观察组无偿献血者初筛、复筛、复检 ALT 合格情况及 ALT 水平。结果干预组无偿献血者献血量足量率、献血反应减弱或消失率高于对照组，献血反应对心理造成影响发生率低于对照组（ P ﹤0.05）；两组无偿献血者献血反应对身体造成影响发生率比较，差异无统计学意义（ P ﹥0.05）。干预组3例有迟发性献血反应史者均未再出现迟发性献血反应，对照组3例有迟发性献血反应史者均再次出现迟发性献血反应。观察组无偿献血者初筛时 ALT 合格率为0，ALT 水平为（49±5）U/ L；复筛时 ALT 合格率为32.7%（98/300），ALT 水平为（43±6）U/ L；复检时 ALT 合格率为86.7%（85/98），ALT 水平为（35±4）U/ L。结论冷刺激干预安全可行，可减少献血反应、迟发性献血反应及一过性 ALT 轻度升高的发生，有助于减轻献血反应严重程度、提高 ALT 合格率。