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目的了解高原献血人群中高原红细胞增多症(HAPC)发病情况及其影响因素。方法收集2015年5-7月在海拔3 000-4 000 m地方献血的289名献血者基本信息、既往病史、体格检查等资料,获得其HAPC患病比例,采用t检验、Wilcoxon秩和检验及Logistic回归等统计方法做单因素或(和)多因素分析。结果收缩压(mm Hg),有、无HAPC的献血者为115.42±14.38vs 121.56±8.42(P<0.01);汉族、藏族与其他少数民族献血者中患HAPC的比例为64.89%(170/262)vs 62.50%(5/8)vs 21.05%(4/19)(P<0.01);从事脑力劳动、不吸烟的献血者患HAPC的比例为81.08%(30/37)、73.25%(178/243),高于体力劳动者和吸烟者(P<0.05);献血者ABO血型中,A、B、O和AB型者患HAPC的比例为45.21%(33/73)vs 63.33%(57/90)vs 69.31%(70/101)vs 70.00%(14/20)(P<0.01)。此外,除单因素分析获得的收缩压、民族、工作性质、吸烟及血型外,经多因素分析显示:年龄(OR=1.333)、舒张压(OR=1.377)、脉搏(OR=1.161)等在HAPC的发生中也有一定影响。结论年龄、民族、工作性质、吸烟、血压、脉搏、ABO血型可能为诱发HAPC的因素,高原采血尤其是应急采血需关注献血者相关资料及参数变化。
Objective To investigate the incidence of high altitude polycythemia (HAPC) and its influencing factors in plateau blood donors. Methods The data of 289 donors who donated blood at 3 000-4 000 m above sea level from May to July in 2015 were collected and their HAPC prevalence was obtained. The t-test and Wilcoxon rank-sum test Logistic regression and other statistical methods to do single factor or (and) multivariate analysis. Results The systolic blood pressure (mm Hg), blood donors with and without HAPC were 115.42 ± 14.38 vs 121.56 ± 8.42 (P <0.01). The proportion of HAPC among Han, Tibetan and other minority donors was 64.89% (170/262 ) vs 62.50% (5/8) vs 21.05% (4/19) (P <0.01). The percentage of HAPC patients who engaged in mental work and non-smoking donors was 81.08% (30/37) and 73.25% (178 / 243), higher than that of manual workers and smokers (P <0.05). The proportion of HAPC in type A, B, O and AB was 45.21% (33/73) vs 63.33% (57 / 90) vs 69.31% (70/101) vs 70.00% (14/20) (P <0.01). In addition, multivariate analysis showed that age (OR = 1.333), diastolic blood pressure (OR = 1.377), pulse (OR = 1.161) The occurrence of HAPC also has some influence. Conclusions Age, ethnicity, working nature, smoking, blood pressure, pulse and ABO blood type may be the factors that induce HAPC. High blood pressure blood collection, especially emergency blood collection, should pay attention to the changes of relevant data and parameters of blood donors.