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目的探讨高原地区献血对血管性血友病因子(vWF)的影响及其临床价值。方法收集了西藏昌都地区自愿献血的血液标本82例,其中多次献血标本42例(献血组),分为低频、中频、高频3个献血亚组,其中低频献血为2次,20例;中频献血为3次~9次,13例;高频献血为≥10次,9例。初次献血前体检合格样本40例(对照组)。用ELISA方法检测献血组和对照组的vWF与人脂蛋白相关磷脂酶A2(Lp-PLA2)的水平,并记录2组相应的血常规和血脂等指标。结果多次献血后vWF浓度明显低于对照组,差异有统计学意义(P<0.05),而献血组Lp PLA2浓度和对照组比较差异无统计学意义(P>0.05);对高原地区献血影响因素的Logistic回归分析表明,vWF下降为多次献血后机体的保护因素;在低频、中频、高频献血亚组的K-M概率分析中,随着献血频次的增加,非血管内皮损伤的概率逐渐升高,差异有统计学意义(χ~2=40.092,P<0.01)。结论 vWF与高原地区多次献血的关系密切,vWF下降是多次献血后机体的保护因素。随着献血次数增多,机体潜在的不良血管内皮状态可能会得到一定的修正或改善。
Objective To investigate the effect of blood donation on von Willebrand factor (vWF) in plateau and its clinical value. Methods Totally 82 blood samples were collected from the voluntary blood donation in Qamdo, Tibet. Among them, 42 donated blood samples were divided into three subgroups: low frequency, medium frequency and high frequency. IF blood donation 3 times to 9 times, 13 cases; high-frequency blood donation ≥ 10 times, 9 cases. Before the first donation of blood samples 40 cases (control group). The levels of vWF and lipoprotein-associated phospholipase A2 (Lp-PLA2) in blood donors and controls were detected by ELISA, and the corresponding indexes of blood and blood lipid were recorded. Results The concentration of vWF after multiple blood donation was significantly lower than that of the control group (P <0.05), but there was no significant difference between the Lp PLA2 concentration in the blood donation group and the control group (P> 0.05) Logistic regression analysis of factors showed that vWF decreased as the protective factor after multiple blood donation; in the probability analysis of KM in subgroup of low, middle and high frequency of blood donation, the probability of non-vascular endothelial injury increased gradually with the increase of blood donation frequency High, the difference was statistically significant (χ ~ 2 = 40.092, P <0.01). Conclusion vWF is closely related to blood donation in many areas of the plateau. The decline of vWF is the protective factor of the body after multiple blood donation. With the increase of blood donation, the potential adverse vascular endothelial status of the body may be revised or improved.