Nishimori Hisakazu, Fujii Nobuharu, Fujii Keiko, Ikeda Tohru, Asano Naomi, Ogo Hiroaki, Yamakawa Miwa, Takagi Naoe, Otsuka Fumio, Ikeda Kazuma
Department of Transfusion Medicine, Okayama University Hospital, Okayama, Japan.
Department of Hematology and Oncology, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
Int J Hematol. 2017 Jun;105(6):812-818. doi: 10.1007/s12185-017-2204-6. Epub 2017 Mar 7.
Studies examining risk factors associated with vasovagal reactions (VVRs) during autologous blood donations, especially in younger subjects, have been limited. The aim of the present study was to define risk factors for VVRs during preoperative autologous blood donation in patients, including those younger than 18 years old. We retrospectively analyzed 4192 autologous, preoperative blood donations between 2007 and 2015 at Okayama University Hospital. Eighty-seven (2.08%) of the patients experienced VVRs. VVRs occurred approximately three times as often in patients 0-17 years old (16/320, 5.0%) than in patients 18 years and older (71/3872, 1.8%). In particular, VVRs occurred more frequently in those 10-13 years old, and decreased with older age (P = 0.006). In a univariate analysis, younger age, lower body mass index, lower systolic blood pressure, lower body weight, lower total blood volume, female gender, first-time collection, and higher heart rate were associated with a higher incidence of VVRs. In a multivariate analysis, lower systolic blood pressure (P < 0.001), higher heart rate (P = 0.007), and first-time collection (P = 0.015), remained independent predictors of VVRs. These results emphasize the need for careful attention during blood collection.
关于自体献血期间与血管迷走神经反应(VVRs)相关的危险因素的研究,尤其是在年轻受试者中,一直较为有限。本研究的目的是确定患者术前自体献血期间发生VVRs的危险因素,包括18岁以下的患者。我们回顾性分析了2007年至2015年在冈山大学医院进行的4192例术前自体献血。87例(2.08%)患者发生了VVRs。0至17岁患者发生VVRs的频率约为18岁及以上患者(71/3872,1.8%)的三倍(16/320,5.0%)。特别是,VVRs在10至13岁的患者中更频繁发生,并随着年龄增长而减少(P = 0.006)。单因素分析显示,年龄较小、体重指数较低、收缩压较低、体重较轻、总血容量较低、女性、首次采血以及心率较高与VVRs的发生率较高相关。多因素分析显示,收缩压较低(P < 0.001)、心率较高(P = 0.007)和首次采血(P = 0.015)仍然是VVRs的独立预测因素。这些结果强调了采血过程中需要密切关注。