摘要
目的探讨平均红细胞体积(MCV)和血红蛋白(Hb)毛细管电泳(HbA2、HbF)联合检测对地中海贫血的诊断价值。方法选择2019年1—12月在高州市中医院北院区经基因检测筛查为地中海贫血的310例孕妇作为研究对象,根据疾病类型分为3个亚组,分别为α-地中海贫血组(176例),β-地中海贫血组(117例)和α合并β-地中海贫血组(17例);另选择同期接受产检且基因检测正常的120例孕妇作为健康对照组。检测两组研究对象的MCV、Hb、平均Hb含量(MCH)以及Hb电泳(HbA2、HbF)结果;绘制受试者工作特征曲线(ROC),计算ROC曲线下面积(AUC),评价单独检测与联合检测对地中海贫血的诊断效能。结果地中海贫血组的MCV、Hb、MCH水平均明显低于健康对照组,HbA2、HbF水平明显高于健康对照组〔MCV(fL):69.81±7.62比86.45±7.56,Hb(g/L):107.92±15.59比132.54±16.68,MCH(pg):21.51±7.94比28.35±6.82,HbA2:0.036±0.005比0.027±0.003,HbF:0.022±0.006比0.019±0.004,均P<0.05〕;β-地中海贫血组、α合并β-地中海贫血组HbA2、HbF水平均明显高于健康对照组〔HbA2:0.055±0.007、0.051±0.006比0.027±0.003,HbF:0.025±0.009、0.021±0.008比0.019±0.004,均P<0.05〕;MCV联合Hb电泳(HbA2、HbF)诊断地中海贫血的AUC分别为0.930、0.913,敏感度分别为89.7%、88.4%,特异度分别为80.8%、79.6%,均明显高于MCV和Hb电泳(HbA2、HbF)单独检测(均P<0.01)。结论与单独检测相比,MCV和Hb电泳联合检测对筛查地中海贫血的诊断价值更高,可为早期干预提供依据。
Objective To investigate the diagnostic value of combined detection of mean corpuscular volume(MCV)and hemoglobin(Hb)capillary electrophoresis(HbA2,HbF)in thalassemia screening.Methods The 310 pregnant women screened for thalassaemia by genetic testing in north campus of Gaozhou Traditional Chinese Medicine Hospital from January to December 2019 were selected,and according to the disease types,the patients were divided into three subgroups:α-thalassemia group(176 cases),β-thalassemia group(117 cases)andα+β-thalassemia group(17 cases);other 120 normal pregnant women undergoing prenatal examination and genetic testing during the same period were selected as healthy control group.The MCV,Hb,mean corpuscular Hb(MCH)and Hb electrophoresis(HbA2,HbF)of two groups were detected.The receiver operating characteristic curve(ROC)was drawn and the area under curve(AUC)was calculated to evaluate the diagnostic efficacy of single detection and combined detection in screening thalassemia.Results The levels of MCV,Hb and MCH in thalassemia group were significantly lower than those in healthy control group,and HbA2 and HbF were higher than those in healthy control group[MCV(fL):69.81±7.62 vs.86.45±7.56,Hb(g/L):107.92±15.59 vs.132.54±16.68,MCH(pg):21.51±7.94 vs.28.35±6.82,HbA2:0.036±0.005 vs.0.027±0.003,HbF:0.022±0.006 vs.0.019±0.004,all P<0.05].The levels of HBA2 and HbF in pregnant women withβ-thalassemia andα+β-thalassemia were significantly higher than those in healthy control group[HbA2:0.055±0.007,0.051±0.006 vs.0.027±0.003,HbF:0.025±0.009,0.021±0.008 vs.0.019±0.004,all P<0.05].The AUC of MCV combined with Hb electrophoresis(HbA2,HbF)in the diagnosis of thalassemia was 0.930 and 0.913,the sensitivity was 89.7%and 88.4%,and the specificity was 80.8%and 79.6%,respectively,which were significantly higher than those of MCV and Hb electrophoresis(HBA2,HbF)detection alone(all P<0.01)Conclusion Compared with single detection,the results of MCV combined with Hb electrophoresis are of higher value in diagnosis o
作者
邓宇运
林杰锋
李雁
Deng Yuyun;Lin Jiefeng;Li Yan(Clinical Laboratory,Gaozhou Traditional Chinese Medicine Hospital,Maoming 525200,Guangdong,China;Clinical Laboratory,Gaozhou Maternal and Child Health Hospital,Maoming 525200,Guangdong,China)
出处
《实用检验医师杂志》
2020年第3期180-183,共4页
Chinese Journal of Clinical Pathologist
