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目的研究武汉地区献血人群转氨酶(ALT)异常升高的原因。方法街头初筛ALT值≥100 U/L的献血者填写《献血者转氨酶异常升高调查表》,对调查表进行分析,对其中不名原因的献血者血浆标本进行HBV、HCV、HEV的检测。结果 189名ALT值≥100 U/L的志愿者中,142名为非病理性因素导致,12名为病理性因素导致,35名为不明原因异常升高。非病理性因素中,排在前四位的是劳累、剧烈运动和重体力劳动、熬夜和饮酒,BMI值高于正常标准的占69.01%。病理性因素中,病毒性肝炎及肝脏疾病仍是主要因素。35名ALT值不明原因异常升高志愿者中,1例抗-HEV IgG反应性标本。结论武汉地区献血人群导致ALT异常升高的主要是非病理性因素,应加强献血前注意事项的宣传。BMI对ALT值的影响应引起重视。ALT是否适用于减少血清学及核酸检测均为阴性的输血性传播病毒的风险仍有待观察。
Objective To study the causes of the abnormal increase of transaminase (ALT) in blood donors in Wuhan. Methods Blood donors with ALT of ≥100 U / L on the street were enrolled in the questionnaire of abnormal elevation of transaminases of blood donors, and the questionnaires were analyzed. The blood samples of donors without known reasons were tested for HBV, HCV and HEV . Results Of the 189 volunteers with ALT ≥100 U / L, 142 were non-pathological factors, 12 were pathological factors and 35 were abnormally elevated for unknown reasons. Among the non-pathological factors, the top four were overworked, strenuous exercise and heavy manual labor, staying up late and drinking alcohol, accounting for 69.01% of patients with BMI values higher than normal. Among the pathological factors, viral hepatitis and liver diseases are still the main factors. Among 35 volunteers with ALT unexplained abnormalities, 1 was anti-HEV IgG reactive specimen. Conclusion The main cause of abnormal ALT in blood donors in Wuhan is non-pathological factors, and publicity of precautions before blood donation should be strengthened. The impact of BMI on the ALT value should be taken seriously. It remains to be seen whether ALT is suitable for reducing the risk of transmissible transmitted viruses that are serologically and nucleic acid-negative.