【摘要】 目的 探究广州地区成分献血者铁代谢现状，分析健康宣教对频繁成分献血者铁缺乏的改善作用。方法 采用广义线性混合效应模型(generalized linear mixed model, GLMM),对2024年1—7月广州血液中心261名符合献血条件的成分献血者开展180 d随访，以血红蛋白(Hb)、血清铁蛋白(SF)、不饱和铁结合力(UIBC)、总铁结合力(TIBC)、铁饱和度(TS)为结局变量，分析性别、年龄段、180 d内献血次数等因素对结局变量的影响并建模。同时运用一般线性模型(general linear model, GLM)重复测量分析，对其中55名献血者实施健康宣教，对比随访、健康宣教前后Hb及铁代谢相关指标的变化差异并建模。结果 广州地区初次献血者与定期成分献血者Hb无显著差异，SF水平显著高于定期献血者(F=6.195,P<0.05)。GLMM模型显示，女性献血者Hb(T=-12.546)与SF(T=-5.829)降低更显著(P值均<0.05);各年龄段对Hb与SF变化无交互效应；180 d内献血次数与Hb变化无交互效应，SF含量随献血次数增加显著下降(以9次及以上为参照组，各组P值均<0.05)。健康宣教干预后，Hb无明显变化，SF含量较干预前升高(干预前后差值为-18.571,P<0.05),但与随访前相比仍呈下降趋势(随访前与干预后差值为23.068,P<0.05)。结论 女性、献血次数是影响成分献血者SF降低的主要因素。健康宣教干预可促进SF含量恢复。可通过延长献血间隔期并强化缺铁相关健康宣教，改善献血者铁缺乏状态。更多还原

【Abstract】 Objective To investigate the current status of iron metabolism among apheresis donors in Guangzhou and analyze the improvement effects of health education on iron deficiency in frequent apheresis donors. Methods Using a generalized linear mixed model(GLMM), a 180-day follow-up was conducted on 261 eligible apheresis donors at the Guangzhou Blood Center from January to July 2024. Hemoglobin(Hb), serum ferritin(SF), unsaturated iron-binding capacity(UIBC), total iron-binding capacity(TIBC), and transferrin saturation(TS) were selected as outcome variables. The effects of gender, age group, and number of donations within 180 days on these outcomes were analyzed and modeled. A general linear model(GLM) with repeated measures was applied to 55 donors who received health education interventions, comparing changes in Hb and iron metabolism-related indicators before and after follow-up and health education. Results No significant difference in Hb levels was observed between first-time and regular apheresis donors, but SF levels were significantly higher in first-time donors(F=6.195, P<0.05). The GLMM revealed that female donors exhibited more significant reductions in Hb(T=-12.546) and SF(T=-5.829)(P<0.05 for both). Age group showed no interactive effects on Hb or SF changes. While number of donations within 180 days had no interactive effect on Hb, SF levels significantly decreased with increased number of donations(using ≥9 donations as the reference group; P<0.05 for all groups). After health education, Hb levels remained unchanged, but SF increased compared to pre-intervention levels(mean difference:-18.571, P<0.05), though a declining trend persisted compared to baseline(mean difference from baseline to post-intervention: 23.068,P<0.05). Conclusion Female and number of donations are primary factors contributing to SF reduction in apheresis donors. Health education interventions promote SF recovery. Extending donation intervals and reinforcing iron deficiency-related health education may improve iron status in donors.更多还原