• 中国科学论文统计源期刊
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  • 美国化学文摘(CA)来源期刊
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临床输血与检验 ›› 2026, Vol. 28 ›› Issue (4): 560-565.DOI: 10.3969/j.issn.1671-2587.2026.04.015

• 调查研究 • 上一篇    下一篇

献血者特征对红细胞输注输血不良反应发生率的影响研究*

华敏玉1, 代华友2, 刘开强3,7, 杨霞4, 李鹏5, 谯铭铭6, 王胜蓝3,7, 黄霞2,7   

  1. 1无锡市中心血站,江苏无锡 214021;
    2重庆市血液中心,重庆 400015;
    3文山州中心血站,云南文山 663099;
    4凉山彝族自治州中心血站,四川西昌 615000;
    5宜昌市红十字中心血站,湖北宜昌 443005;
    6山东省血液中心,山东济南 250014;
    7中国输血协会血液安全监测专业委员会
  • 收稿日期:2026-07-08 出版日期:2026-08-20 发布日期:2026-08-26
  • 通讯作者: 黄霞,主要从事血液质量管理和血液安全监测体系建立研究,(E-mail)xiahuangyy@163.com。
  • 作者简介:华敏玉,主要从事采供血过程管理、血液安全监测方面研究,(E-mail)1070521618@qq.com。并列第一作者:代华友,主要从事血液质量管理与控制和血液安全监测工作,(E-mail)57665214@qq.com。
  • 基金资助:
    *本课题受中国输血协会圣湘输血医学发展基金(No.CSBT-SX-2024-01)资助

Study on the Influence of Characteristics of Blood Donors on the Incidence of Adverse Reactions of Red Blood Cell Transfusion

HUA Minyu1, DAI Huayou2, LIU Kaiqiang3,7, YANG Xia4, LI Peng5, QIAO Mingming6, WANG Shenglan3,7, HUANG Xia2,7   

  1. 1Wuxi Blood Center, Wuxi, Jiangsu 214021;
    2Chongqing Blood Center, Chongqing 400015;
    3Wenshan Zhou Blood Center, Wenshan, Yunnan 663099;
    4Center Blood Stations of Liangshan, Xichang, Sichuan 615000;
    5Blood station of Yichang Red Cross Center, Yichang, Hubei 443005;
    6Shandong Blood Center, Jinan, Shandong 250014;
    7China Blood Transfusion Association Blood Safety Monitoring Professional Committee
  • Received:2026-07-08 Online:2026-08-20 Published:2026-08-26

摘要: 目的 系统阐释献血者各项生物学特征对红细胞输注非溶血性发热反应(febrile non-hemolytic transfusion reaction, FNHTR)、过敏性输血反应(allergic transfusion reaction, ATR)发生率的差异化影响,明确其独立相关危险因素,为采供血机构前置风险筛查、临床精准用血提供循证依据。方法 纳入全国6家血液安全监测哨点医院2020年1月—2025年12月共337 756袋红细胞输注记录,采集对应献血者的特征(性别、年龄、献血次数、ABO血型)信息,同步纳入不同红细胞类型、监测哨点作为混杂变量,采用卡方检验完成单因素分析,通过二分类非条件Logistic回归模型筛选两类不良反应的独立影响因素。结果 FNHTR总发生率为0.099%,最高是悬浮红细胞(0.420%),最低是洗涤红细胞(0.036%);ATR总发生率为0.086%,最高是辐照悬浮红细胞(0.230%),最低是去白细胞悬浮红细胞(0.065%)。单因素分析显示,血液类型、不同哨点单位对FNHTR和ATR的发生皆有统计学差异,献血者特征对FNHTR发生率的影响均有统计学意义,而ATR均无统计学差异;多因素Logistic回归分析结果显示,血液类型与监测哨点是FNHTR和ATR独立影响因素,献血者特征均非FNHTR发生的独立影响因素,献血者性别为ATR独立影响因素,男性献血者红细胞输注后 ATR 发生风险显著低于女性。结论 献血者生物学特征对两类不良反应的作用强度与路径存在显著差异,白细胞去除、辐照、洗涤等血液制备与临床监测异质性是更关键的影响因素,未来应建立“献血者—血液—受血者”关联数据库,推动精准输血。

关键词: 献血者特征, 输血不良反应, 非溶血性发热反应, 过敏性输血反应

Abstract: Objective Systematically explain the differential effects of various biological characteristics of blood donors on the incidence of febrile non-hemolytic transfusion reaction and allergic transfusion reaction in red blood cell transfusion, and clarify their independent related risk factors, so as to provide evidence-based basis for pre-risk screening and clinical accurate blood use in blood collection and supply institutions. Methods A total of 337 756 bags of red blood cell infusion records from January 2020 to December 2025 in six hemovigilance sentinel hospitals in China were included, and the information of gender, age, blood donation times and ABO blood group of the corresponding blood donors were collected. Different types of red blood cell preparations and monitoring sentinel sites were simultaneously included as confounding variables, and univariate analysis was completed by chi-square test. Independent influencing factors of two kinds of adverse reactions were screened by binary unconditional Logistic regression model. The adverse blood transfusion reactions reported by 6 hospitals participating in HV in China from January 2020 to December 2025 and all clinical red blood components were collected, and the influence of gender, age, blood donation times and ABO blood type of related blood donors on the occurrence of adverse blood transfusion reactions was analyzed. The differences of ATR and FNHTR occurred in the infusion of different red blood cell blood components. Results The total incidence of FNHTR was 0.099%, the highest was suspended red blood cells (0.420%) and the lowest was washed red blood cells (0.036%). The total incidence of ATR was 0.086%, the highest was irradiated suspended red blood cells (0.230%) and the lowest was leucocyte-depleted suspended red blood cells (0.065%). Univariate analysis showed that there were statistical differences in the incidence of FNHTR and ATR between blood types and different sentinel units, and the influence of blood donor characteristics on the incidence of FNHTR was statistically significant, but there was no statistical difference in ATR. Multivariate Logistic regression analysis showed that blood type and monitoring sentinel were independent influencing factors of FNHTR and ATR, the characteristics of blood donors were not independent influencing factors of FNHTR, and the gender of blood donors was independent influencing factor of ATR. The risk of ATR in male blood donors after red blood cell transfusion was significantly lower than that in women. Conclusion There are significant differences in the intensity and path of the biological characteristics of blood donors to the two kinds of adverse reactions, and the heterogeneity of blood product processing technology and clinical monitoring is the more critical influencing factor. In the future, an associated database of "blood donors, blood products and recipients" should be established to promote accurate blood transfusion.

Key words: Characteristics of blood donors, Adverse reactions of blood transfusion, Febrile non-hemolytic transfusion reaction, Allergic transfusion reaction

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