RESUMO
【Objective】 To investigate the risk factors of vasovagal reactions(VVR) related to plasma donation, so as to put forward clinical suggestions for early identification and accurate intervention of high-risk groups to ensure the safety of plasma donation. 【Methods】 The demographic characteristics(i.e. gender, age, weight) and records of plasma donors(donation history, pulse before plasma donation, duration of collection, etc.) were collected from July to December 2019 in a region of Sichuan. Based on logistic regression analysis, the correlation between these factors and the risk of VVR was explored. 【Results】 The information of 69 172 donors was collected, and the incidence of VVR was 7.04‰. The risk of VVR was reduced by 99% in the group with plasma collection duration less than 30 minutes compared with the group with plasma collection duration more than 50 minutes(OR, 0.01; 95% CI, 0.00~0.01; P<0.001). The risk of male group was 94 % lower than that of female group(OR, 0.06; 95% CI, 0.04~0.10; P<0.001). Compared with the 45~50 kg group, the risk of weight greater than 80 kg group decreased by 80%(OR, 0.20; 95% CI, 0.09~0.42; P<0.001). The risk of repeated donation group was 34 % lower than that of the first time donation group(OR, 0.66; 95% CI, 0.47~0.91; P<0.001). The risk of VVR in the group with pulse greater than 90 bpm before plasma donation was 2.43 times that in the 60~69 bmp group(OR, 2.43; 95% CI, 1.75~3.36; P<0.001). 【Conclusion】 Duration of plasma collection, gender, weight, frequency of plasma donation, pulse before plasma donation and donor status are independent risk factors for plasma donation-related VVR. Among them, plasma collection duration, gender and weight were the main independent risk factors for plasma donation-related VVR. For donors with plasma collection duration more than 50 minutes, female and low weight, higher risk of VVR was presented and more preventive intervention should be given.
RESUMO
ObjectiveTo investigate the early diagnosis value of IMA and D-dimer and cTn Ⅰ in ACS.MethodsAll the 113 blood samples of patients with chest pain in the emergency department of the Third Hospital of Hebei Medical University were selected.Thirty healthy people were selected as the control group.Patients were divided into two groups:one of 52 cases was within 3 hours after onset of chest pain.the other of 61 cases was between 3 to 6 hours.According to the final clinical diagnosis,31 cases were divided into non-ischemic chest pain group (NICP) and 82 cases were divided into the ACS group.The ACS group was divided into the UA group (51 cases),NSTEMI group (18 cases) and STEMI group (13 cases).IMA was measured with albumin-cobalt binding test,and D-dimer was measured with the automated blood coagulation analyzer,and cTn Ⅰ was measured with the automatic biochemical analyzer.Levels of IMA,D-dimer,cTn Ⅰ were compared in the different groups and their sensitivity,specificity and accuracy to the early diagnosis of ACS were evaluated by Four format diagnositic test.ResultsThe levels of IMA in ACS group,which include the UA group,NSTEMI group and STEMI group were (0.722 ± 0.181 ),(0.601 ± 0.122),(0.631 ± 0.153 ) ABSU respectively.The levels of D-dimer were ( 0.485 ± 0.124 ),( 0.571 ± 0.181 ),(0.748 ± 0.094 ) mg/L respectively.The levels of cTn Ⅰ were ( 0.076 ± 0.027 ),( 0.059 ± 0.038 ),(0.065 ± 0.015 )μg/L respectively.Concentrations of IMA,D-dimer and cTn Ⅰ in ACS group were significantly higher than those of the NICP group [IMA (0.338 ± 0.065 ) ABSU,D-dimer (0.368 ± 0.078 )mg/L,cTn Ⅰ (0.022 ±0.007) μg/L] and the controls group [IMA (0.292 ±0.058) ABSU,D-dimer (0.267 ±0.052) mg/L,cTn Ⅰ (0.029 ± 0.016) μg/L].There were significant differences between the ACS group and the NICP group and the control group,F value was 3.613,3.289 and 3.521 respectivily,and P ＜0.05.The levels of IMA in ACS group within 3 hours and between 3 to 6 hours,which is (0.665 ±0.104 ),(0.520 ± 0.073 ) ABSU,were significantly higher than that of the controls (0.292 ± 0.058 ) ABSU ( F value was 3.58,P ＜ 0.05 ).The levels of D-dimer and the cTn Ⅰ in the group between 3 to 6 hours [which were (0.634 ±0.213 ) mg/L and (0.079 ±0.032) μg/L] were significantly higher than those of the controls [(0.267 ±0.052) mg/L and (0.029 ±0.016) μg/L] (q was4.24 and 3.46,P ＜0.05).The sensitivity,specificity and accuracy was 83.36％,70.97％ and 81.42％ of the IMA in a separate diagnosis of ACS,but the sensitivity,specificity and accuracy were 97.56％,58.06％ and 86.73％ of the IMA,D-dimer and cTn Ⅰ with the affiliation diagnosis.ConclusionThe serum IMA is a more sensitive indicator of ACS in early myocardial ischemia than cTn Ⅰ and plasma D-dimer.Serum IMA in combination with D-dimer and cTn Ⅰ could improve the sensitivity and specitivity,and had value to guide cinical diagnosis of ACS in the early stage.
