红细胞渗透脆性试验参考区间的建立及在地中海贫血筛查中的初步应用  

Establishment of reference interval of erythrocyte osmotic fragility and preliminary application in thalassemia screening

作　　者：何思华 方艳平[1] 林丽娟[1] 李紫岩 黄振艺 周万军[3] 江凌晓[1] HE Si-hua;FANG Yan-ping;LIN Li-juan;LI Zi-yan;HUANG Zhen-yi;ZHOU Wan-jun;JIANG Ling-xiao(Department of Laboratory Medicine,Zhujiang Hospital,Southern Medical University,Guangzhou,Guangdong 510282,China;Department of Laboratory Medicine,Central Hospital of Panyu district,Guangzhou,Guangdong 511400,China;Department of Medical Genetics,Southern Medical University,Guangzhou,Guangdong 510515,China)

机构地区：[1]南方医科大学珠江医院检验医学部,广东广州510282 [2]广州市番禺区中心医院检验科,广东广州511400 [3]南方医科大学医学遗传学教研室,广东广州510515

出　　处：《热带医学杂志》2022年第11期1478-1481,1519,共5页Journal of Tropical Medicine

基　　金：国家自然科学基金(81972008)

摘　　要：目的通过分析健康人群中散射比浊法测得的红细胞渗透脆性(EOF)分布特征,建立南方医科大学珠江医院实验室的EOF的参考区间,并对其在地中海贫血(以下简称“地贫”)筛查的应用进行初步探讨。方法检测2451名健康查体者剩余样本的EOF,并依据其分布特征建立生物参考区间;再选取其中170名应用传统试管法平行进行红细胞渗透脆性的定性检测,比较两种方法的检测结果一致性;最后检测122例地贫筛查者的EOF,以基因检测结果为金标准,初步评价其在地贫筛查中的临床应用价值。结果依据其分布特征,EOF的参考区间为男性?73%、女性?74%。以此为阴阳性界值,其测定结果与传统试管法的检测结果差异无统计学意义(P?0.05)。单独应用到地贫筛查时,EOF敏感性为73%、特异性为95%、阳性预期值为81%、阴性预期值为92%;联合平均红细胞体积(MCV)、平均红细胞血红蛋白浓度(MCH)检测后,敏感性为93%、特异性为83%、阳性预期值为64%、阴性预期值为97%。结论自动化散射比浊法测红细胞渗透脆性的生物参考区间为男?73%、女?74%。与MCV、MCH联合使用可显著提高地贫筛查的敏感性与阴性预期值。Objective To establish the reference interval of erythrocyte osmotic fragility(EOF)measured by scatteringnephelometry in the laboratory of Zhujiang Hospital by analyzing the distribution characteristics of EOF in healthy people,and evaluate the clinical application of EOF testing in thalassemia screening.MethodsA total of 2451 samples fromhealthy people were detected,and a biological reference interval was established according to distribution characteristics ofEOF.Of these,170 were selected and using the traditional EOF tube method to evaluate the consistency of the two methods.Finally,122 thalassemia screeners were tested for EOF and the thalassemia gene.Based on the results of thalassemiagenetic testing,the clinical application value of EOF test in thalassemia screening was evaluated.ResultsAccording to thedistribution characteristics of EOF,the reference interval of our laboratory was male>73%and female>74%.Based onthese criteria,there was no statistical difference between the scattering nephelometry and the traditional tube method forEOF detection(P>0.05).When applied for thalassemia screening,the sensitivity,specificity,expected positive value andexpected negative value of EOF by scattering nephelometry were 73%,95%,81%and 92%,respectively.If combined withmean corpuscular volume(MCV)and mean corpuscular hemoglobin(MCH),the above indicators were 93%,83%,64%and 97%,respectively.ConclusionsThe reference interval of automated scattering nephelometry was male>73%andfemale>74%.EOF combined with MCV and MCH could significantly improve the sensitivity and negative expectations ofthalassemia screening.

关 键 词：散射比浊法 红细胞渗透脆性 参考区间 地中海贫血 

分 类 号：R556.61[医药卫生—血液循环系统疾病]