红细胞各参数及HbA2的测定对成人东南亚缺失型α-珠蛋白生成障碍性贫血筛查的临床价值  

Clinical value of RBC parameters and HbA2 detection in screening adult Southeast Asia deletion alpha thalassemia

作　　者：梁培松[1] 王结珍[1] 王伟佳[1] 傅冰洁[1] 冯砚平[1] 王楠[1] 

机构地区：[1]中山大学附属中山市人民医院,广东中山528400

出　　处：《国际检验医学杂志》2013年第11期1388-1389,共2页International Journal of Laboratory Medicine

摘　　要：目的探讨MCV、MCH、MCHC、RDW-CV、HbA2五项指标的测定对成人东南亚缺失型α-珠蛋白生成障碍性贫血的临床价值。方法对经基因诊断的200例——SEA/αα患者和100例健康对照进行血常规分析和血红蛋白电泳测定;采用ROC曲线分析MCV、MCH、MCHC、RDW-CV、HbA2的最佳截断点。结果——SEA/αα组与健康对照组五项指标相比较差异有统计学意义(P<0.01)。以基因诊断的结果为金标准,MCV、MCH、MCHC、RDW-CV、HbA2五项指标ROC曲线下面积分别为0.990、0.988、0.961、0.986和0.761;其最佳截断值为75.2fL、24.1pg、323.26g/L、13.55%和2.45%;其诊断——SEA/αα地贫的灵敏度分别为94.5%、93.5%、82.5%、95.0%、67.0%,特异度分别为98.0%、96.0%、94.0%、96.0%、76.0%。结论 MCV、MCH、MCHC、RDW-CV、HbA2可作为诊断和筛查——SEA/αα地贫的参考依据。Objective To explore the clinical values of detection using 5 indicators including MCV,MCH,MCHC,RDW,CV and HbA2 in adult Southeast Asia deletion alpha thalassemia.Methods 200 patients genetically diagnosed as --SEA/αα and 100 healthy people were subjected to blood routine analysis and hemoglobin electrophoresis.ROC curve was used to analyze the best cut-off points of MCV,MCH,MCHC,RDW,CV and HbA2.Results Compared with the 5 indicators of patients in --SEA/αα group and healthy people,differences showed statistical significance（P0.01）.Results of genetic diagnosis served as gold standard,areas under ROC curves of 5 indicators MCV,MCH,MCHC,RDW,CV and HbA2 were 0.990,0.988,0.961,0.986 and 0.761,respectively,and their best cut-off points were 75.2 fL,24.1 pg,323.26 g/L,13.55% and 2.45%,respectively.Diagnostic sensitivity of --SEA/αα were 94.5%,93.5%,82.5%,95.0% and 67.0%,and the specificity were 98.0%,96.0%,94.0%,96.0% and 76.0%,respectively.Conclusion MCV,MCH,MCHC,RDW,CV and HbA2 may be used as reference of diagnosis and screening of --SEA/αα.

关 键 词：Α-地中海贫血 红细胞参数 ROC曲线 

分 类 号：R556[医药卫生—血液循环系统疾病]