孕妇珠蛋白生成障碍性贫血的临床血液学筛查指标分析  

Analysis of the Hematological Parameters of Pregnant Women with Thalassemia

作　　者：喻晶[1] 张恋[1] 刘晓翌[1] 张银汉[1] 

机构地区：[1]北京大学深圳医院检验科,广东深圳518036

出　　处：《现代检验医学杂志》2013年第1期138-140,共3页Journal of Modern Laboratory Medicine

摘　　要：目的 探讨孕妇珠蛋白生成障碍性贫血（俗称地中海贫血）的血液学指标包括平均红细胞体积（MCV）,红细胞脆性（EF）,血红蛋白A2（HbA2）对孕妇珠蛋白生成障碍性贫血（简称地贫）筛查的应用价值,减少孕妇珠蛋白生成障碍性贫血的漏诊.方法 对基因确诊的156例珠蛋白生成障碍性贫血杂合子孕妇,168例珠蛋白生成障碍性贫血杂合子非孕妇,103例正常孕妇及101例正常非孕妇进行血常规,EF,血红蛋白电泳检查,分析MCV,EF和HbA2血液学指标,评价其筛查孕妇珠蛋白生成障碍性贫血的诊断价值.结果 ①健康孕妇和健康非孕妇的MCV,EF及HbA2分别为（88.37±7.51 vs 79.94±12.73）fl,（77.01±8.45 vs 73.27±13.57）%,（2.71±0.50 vs 2.47±0.53）%,健康孕妇的MCV及HbA2比健康非孕妇明显增高,差异具有统计学显著性意义（t=-3.025,-5.44,P〈0.05）.②α,β珠蛋白生成障碍性贫血孕妇及健康孕妇的MCV,EF及HbA2分别为（72.36±7.99,65.65±11.70 vs 88.37±7.51）fl,（56.21±13.76,50.56±12.17 vs 73.27±13.57）%和（2.77±1.15,4.96±1.14 vs 2.47±0.53）%,α及β珠蛋白生成障碍性贫血孕妇的MCV,EF均明显低于健康孕妇（t=10.62～14.26,P〈0.05）;β珠蛋白生成障碍性贫血孕妇HbA2明显高于健康孕妇（t=11.52,P〈0.05）.③α珠蛋白生成障碍性贫血孕妇及非孕妇的MCV,EF及HbA2分别为（72.36±7.99 vs 68.86±9.29）fl,（56.21±13.76 vs 52.75±18.67）%和（2.77±1.15 vs 2.18±0.61）%;β珠蛋白生成障碍性贫血孕妇及非孕妇的MCV,EF及HbA2分别为（65.65±11.70 vs 63.51±5.13）fl,（50.56±12.17 vs 50.34±11.35）%和（4.96±1.14 vs 5.39±0.70）%,α珠蛋白生成障碍性贫血孕妇的MCV,HbA2均明显高于α珠蛋白生成障碍性贫血非孕妇（t=-3.07,-3.763,P〈0.05）;β珠蛋白生成障碍性贫血孕妇的HbA2明显低于β珠蛋白生成障碍性贫血非孕妇（t=2.215,P〈0.05）.结论 珠蛋白生成障碍性贫血孕妇的MCV,HbA2与非孕妇存在显著差�Objective To evaluate the value of the mean corpuscular volume（MCV）, hemoglobin A2 （HbA2） and erythrocyte fragility （EF） in the diagnosis of pregnant women with thalassemia. Methods The tests of complete blood count,erythrocyte fragility （EF） and Hb electrophoresis were applied in 103 healthy pregnant women, 156 pregnant women with thalassemia, 101 healthy non pregnant women and 168 non pregnant women with thalassemia, which all confirmed by molecular biology technique. Evaluated the diagnostic values of MCV,EF and HbA2 in the screening of thalassemia. Results （1）The MCV value of the pregnant women was dramatically higher than that of the non pregnant women （88.37 ±7.51fl vs 79. 94± 12.73 fl,t= -5.44, P〈0.05）. （2）Compared with the healthy pregnant women group, the values of MCV and EF in the pregnant women with thalassemia group were verified to be significantly lower （t= 10.62-14.26,P〈0.05）, but the HbA2 value in pregnant women with β thalassemia was significantly higher （t= 11.52, P（0. 05）. （3）The values of MCV and HbA2 in pregnant women with thalassemia were obviously higher than those in non-pregnant women with thalassemia （t= -3.07, -3. 763, P〈0. 05）. The HbA2 value in pregnant women with β thalassemia was obviously lower than that in non-pregnant women with β thalassemia （t = 2. 215, P〈0.05）. Conclusion The values of MCV and HbA2 in pregnant women with thalassemia were found to be significantly different from those in non-pregnant women with thalassemia. The better understanding of hematological parameters of pregnant women helps to screen the pregnant women with thalassemia more accurately.

关 键 词：珠蛋白生成障碍性贫血 平均红细胞体积 红细胞脆性 血红蛋白A2 孕妇 

分 类 号：R556.61[医药卫生—血液循环系统疾病] R446.111[医药卫生—内科学]