地中海贫血表型阳性平均红细胞体积和平均血红蛋白浓度截断值及应用  

Ascertaining and Application of Cutoff Values of Mean Corpuscular Volume and Mean Hemoglobin Concentration in Positive Thalassemia Phenotype People

作　　者：周天红[1] 刘志昂[1] 罗瑞贵[1] 李平萍[1] 黃蒙莎 兰小英[1] 王丽[1] 黄慧婷[1] 韦炅[1] 张天朗[1] 李静[1] 张新华[1] 

机构地区：[1]解放军303医院血液科,南宁530021

出　　处：《华南国防医学杂志》2007年第4期1-2,7,共3页Military Medical Journal of South China

基　　金：广西省自然科学基金(桂科基0447104)

摘　　要：目的探讨平均红细胞体积(MCV)和平均血红蛋白浓度(MCH)在地贫筛查中的诊断截断值及应用价值。方法在南宁农村育龄夫妇地贫筛查中以血清铁蛋白正常的经基因分析确认的153例健康成人、55例β地贫杂合子、76例α地贫1、59例α地贫2和18例不贫血或只有轻度贫血的αβ复合型地贫MCV和MCH通过受试者工作曲线确定其地贫筛查截断值,并以确定的截断值分析其临床诊断意义。结果诊断地贫的截断值分别为MCV≤78.25fl和MCH≤25.65pg,此截断值的敏感度和特异度分别为MCV:85.6%和94.8%,MCH:82.7%和94.8%。55例β地贫杂合子和18例复合型地贫MCV和MCH均低于上截断值,76例α地贫1除1例MCH高于截断值外其它均低于截断值,59例α地贫2中30例MCV低于上截断值,24例MCH低于上截断值,而健康成人中分别有8例MCH和/或MCV低于上截断值。结论以MCV≤78.25fl和MCH≤25.65pg作为地贫表型阳性截断值进行地贫筛查有较高的应用价值。Objective To investigate the cutoff values of mean corpuscular volume （MCV） and mean hemoglobin concentration （MCH） for screening thalassemia and the value of their applications. Methods The husbands and wives with reproductive ages in the country of Nanning were screened for thalassemia. The Gene analysis showed that of 361 reproductive age young people with normal serum ferritin, 153 were healthful, 55 carried 13 thalassemia heterozygote, 76 suffered from thalassemia 1, 59 from thalassemia 2, and 18 from α and β compound thalassemia with mild or no anemia. Cutoff values of MCV and MCH for diagnosing thalassemia were ascertained by receiver operating curve （ROC） and their application were investigated. Results Cutoff value for diagnosing thalassemia is MCV≤78. 25fl and MCH≤25. 65pg, respectively. The sensibility and specificity of the ascertained cutoff value were 85.6% and 94. 8% for MCV,82. 7% and 94. 8% for MCH, respectively. In 55 cases with β thalassemia heterozygote and 18 with compound thalassemia, MCV and MCH were lower than the above-mentioned cutoff value. In 76 case with α thalassemia 1, except 1 case with higher MCH than the cutoff value, MCV and MCH were also lower than the above-mentioned cutoff value. Of 59 cases with α thalassemia 2, 30 had higher MCV and 24 had lower MCH than the above-mentioned cutoff value. In the healthful adults, however, there were 8 cases with lower MCV and/or MCH than the cutoff value. Conclusion MCV≤78. 25fl and MCH≤ 25.65pg used as the cutoff value for diagnosing thalassemia is rather reasonable.

关 键 词：地中海贫血 筛查 MCV MCH 截断值 

分 类 号：R735.2[医药卫生—肿瘤]