中国输血杂志2026，Vol.39Issue(3)：367-372,6.DOI:10.13303/j.cjbt.issn.1004-549x.2026.03.009
南宁地区女性献血者HLA抗体与妊娠因素相关性及随机森林模型预测价值研究
Study on the correlation between HLA antibodies and pregnancy-related factors,and the predictive value of a ran-dom-forest model among female blood donors in Nanning
摘要
Abstract
Objective To explore the association between the HLA antibody positivity rate in female blood donors and pregnancy history,number of pregnancies,interval from the last pregnancy to blood donation,and age,to identify associat-ed variables using a univariate generalized additive model(GAM),and to further analyze the predictive role of characteris-tic variables for HLA antibody positivity using a random forest model.Methods HLA antibody detection was performed on 391 female blood donors using the Luminex immunomagnetic bead method.The correlation between pregnancy-related fac-tors and HLA antibodies was analyzed using the Chi-square test.Based on R software,a univariate GAM was first construc-ted to analyze the association types between characteristic variables and the HLA antibody positivity rate,followed by the construction of a random forest model to evaluate the predictive value of the variables.Results Among the 391 female blood donors without a transfusion history,the overall HLA antibody positivity rate was 26.34%.The positivity rate in do-nors with a pregnancy history was significantly higher than that in those without(30.09%vs 9.72%,P<0.05),and HLA antibody positivity rate increased linearly with the number of pregnancies(P<0.05).In the univariate GAM,age and num-ber of deliveries exhibited a non-linear association with the HLA antibody positivity rate(the positivity rate increased sharply between 25-35 years of age and stabilized after 3 deliveries).Besides,the interval from the last pregnancy to blood dona-tion showed a linear association with the HLA antibody positivity rate,and the positivity rate decreased as the interval pro-longed(P<0.05).In the random forest model,age(mean decrease gini=29.26)and interval from the last pregnancy to blood donation(mean decrease gini=22.02)were core predictive variables:age was more conducive to identifying positive samples,while the interval from the last pregnancy to blood donation was more helpful for excluding negative samples.The number of deliveries(mean decrease accuracy=16.98)made a significant contribution to predicting positive samples,whereas the number of abortions had no impact.The model had an AUC of 0.583(95%CI:0.593 8-0.770 2),indicating a certain predictive value.Conclusion The associated variables identified by the univariate GAM model,including age,interval from the last pregnancy to blood donation,and number of deliveries,provide a basis for key variables in the random forest model.All three variables have predictive value for HLA antibody positivity,which can provide evidence-based sup-port for personalized transfusion management and stratified screening of female blood donors in this region.关键词
女性献血者/HLA抗体/妊娠/随机森林模型Key words
female blood donors/HLA antibodies/pregnancy/random forest model分类
医药卫生引用本文复制引用
卢芳,莫慧慧,苏武锦,钟周琳,李恒聪,黄雨晨,陈雨茜,李丽兰,周燕..南宁地区女性献血者HLA抗体与妊娠因素相关性及随机森林模型预测价值研究[J].中国输血杂志,2026,39(3):367-372,6.基金项目
中国输血协会威高基金科研基金(CSBT-WG-2023-06),广西自然科学基金(2023GXNSFAA026300),广西壮族自治区卫生健康委员会自筹经费科研课题(Z-A20221261,Z-A20251073),南宁市第四周期医学重点学科建设项目 （CSBT-WG-2023-06）
