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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2 352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。
Objective To investigate the effect of cold stimulation on reducing blood donation reaction and transiently increasing alanine aminotransferase (ALT). Methods From October 2003 to October 2013, a total of 2,352 unpaid blood donors were found to have blood donation reaction, delayed blood donation reaction or blood donation reaction before blood donation in Handan City Blood Center. Among them, blood donation reaction history , The history of delayed blood donation or blood donation for the first time, but before donating blood donation reaction in 200 cases, according to the cold stimulation intervention is divided into intervention group and control group, each 100 cases; the other selected the same period appeared transient ALT 300 patients with mildly elevated blood donation as observation group. The control group unpaid blood donors were routinely treated, and the unpaid blood donors in the intervention group and the observation group were subjected to cold stimulation intervention. The comparison of blood donation amount, blood donation reaction disappearance or disappearance of blood donation response to psychological and physical effects in intervention group and control group was observed, and the late onset of delayed blood donation reaction was observed in intervention group and control group Blood donation reaction and observation group unpaid blood donors screening, re-screening, retest ALT and ALT levels. Results The blood donation rate, blood donation response rate or disappearance rate in blood donation group in intervention group were higher than those in control group. The incidence of psychological impact of blood donation reaction was lower than that of control group (P <0.05) The incidence of the impact of comparison, the difference was not statistically significant (P> 0.05). In the intervention group, delayed blood donation reaction did not appear again in 3 patients who had a history of delayed blood reaction. In the control group, delayed blood donation reaction occurred again in 3 patients who had a history of delayed blood reaction. ALT level was (49 ± 5) U / L at the initial screening of unpaid blood donors in observation group; the pass rate of ALT was 32.7% (98/300) and the level of ALT was (43 ± 6) U / L; ALT pass rate was 86.7% (85/98) and ALT level (35 ± 4) U / L at the time of retest. Conclusion Cold stimulation is safe and feasible, which can reduce the occurrence of blood donation reaction, delayed blood donation reaction and slight transient increase of ALT. It is helpful to reduce the severity of blood donation and improve the pass rate of ALT.