平均红细胞体积和平均红细胞血红蛋白含量筛查妊娠合并轻型地中海贫血的价值  

Value of red cell mean corpuscular volume and mean corpuscular hemoglobin in screening and identifying of pregnant women complicated with mild thalassemia

作　　者：王耕[1] 王琳[2] 

机构地区：[1]广西北海市妇幼保健院,536000 [2]广西壮族自治区人民医院,530021

出　　处：《中国优生与遗传杂志》2011年第4期65-66,共2页Chinese Journal of Birth Health & Heredity

摘　　要：目的探讨平均红细胞体积(MCV)、平均红细胞血红蛋白含量(MCH)检测在筛查妊娠合并轻型地中海贫血(地贫)中的价值。方法 1514例孕妇在首次产前检查时,同时检查外周血MCV、血红蛋白浓度(Hb)、MCH及血红蛋白电泳等指标,依据首次产前检查时血常规及血红蛋白电泳结果分3组:Ⅰ组127例:Hb<100g/L伴血红蛋白电泳异常;Ⅱ组69例:Hb<100g/L而血红蛋白电泳正常;对照组1318例:Hb>100g/L及血红蛋白电泳正常;以基因诊断作为地贫诊断金标准。结果Ⅰ组MCV及MCH最低,明显低于Ⅱ组和对照组(P<0.01),而Ⅱ组与对照组无显著性差异(P>0.05)。MCV及MCH检测筛查地贫与基因诊断结果比较:灵敏度(Se)98.06%、特异度(Sp)72.04%、假阳性率0.28、假阴性率0.02、准确度90.31%、阳性预测值79.53%、阴性预测值90.30%、阳性似然比3.50、阴性似然比0.028。结论轻型地贫者有MCV、MCH降低的特征,临床上检测MCV、MCH筛查妊娠合并轻型地贫,其灵敏度高,且特异度也较高,假阳性率和假阴性率低。方法简便、实用、经济。可作为基层医院轻型地贫的筛查指标。Objective： To study the value of red cell mean corpuscular volume（MCV） and mean corpuscular hemoglobin（MCH） in screening and identifying of pregnant women complicated with mild thalassemia.Methods： Red blood cell（RBC）,MCV,MCH,level of hemoglobin（Hb）,mean corpuscular hemoglobin concentration（MCHC） and hemoglobin electrophoresis analysis of peripheral blood were measured in 1514 cases of pregnant women when they took pre-natal examination in the first time.The pregnant women were divided into three groups according to the results of blood routine test and hemoglobin electrophoresis analysis： group Ⅰ（n=127）,women who with Hb100g/L and abnormal distribution of hemoglobin;group Ⅱ（n=69）：women who with Hb100g/L and normal distribution of hemoglobin;control group（n=1318）：women who with Hb100g/L and normal distribution of hemoglobin;the gold standard diagnosis of thalassemia is gene diagnosis.Results： MCV and MCH were the lowest in group I（P0.01） when compared with those of group Ⅱ and control group,there′s no significant difference between group Ⅱ and control group（P0.05）.Thalassemia can be diagnosed by MCV and MCH with a sensitivity of 98.06%,a specificity of 72.04%,false positive rate of 0.28,false negative rate of 0.02,accuracy of 90.31%,positive predictive value of 79.53%,negative predictive value of 90.3%,positive likelihood ratio of 3.5 and negative likelihood ratio of 0.028.Conclusions： Low MCV and MCH is a character of mild thalassemia.MCV and MCH can be used for further clinical screening and identifying of mild thalassemia.

关 键 词：MCV MCH 地中海贫血 

分 类 号：R556.61[医药卫生—血液循环系统疾病] R714.2[医药卫生—内科学]