红细胞参数中MCH指标筛查地中海贫血比MCV指标更可靠  

More reliable erythrocyte parameter MCH than MCV for screening thalassaemia trait

作　　者：李恋湘 肖奇志[1,2] 周玉球[1,2] 

机构地区：[1]珠海市妇幼保健院检验科 [2]珠海市医学遗传研究所,广东珠海519001

出　　处：《国际检验医学杂志》2014年第14期1914-1915,1918,共3页International Journal of Laboratory Medicine

基　　金：广东省科技计划项目(2009A030301002);广东省自然科学基金(04101691)

摘　　要：目的对红细胞指标红细胞平均体积(MCV)和红细胞平均血红蛋白(MCH)筛查地贫的可靠性进行比较。方法将一份MCV处于临界值的新鲜静脉血于1d内送到珠海市21家医疗机构进行全血细胞分析,然后统计分析得出室间和室内MCV和MCH的变异系数(CV)和偏倚值。此外,另抽取EDTA抗凝静脉血10份,一分为二,观察温度和放置时间对此两个指标的影响。结果该市室间MCV的CV值(4.1%)明显大于MCH的CV值(2.8%),MCH检测结果的合格率(100%)明显高于MCV(66.7%)(P<0.05)。全血标本在两种温度条件(室温与冷藏)下保存72h,MCH指标变化不大(P>0.05)。血液标本冷藏72h时,MCV与即测值比较差异无统计学意义(P>0.05),室温保存48h时,MCV显著升高(P<0.05)。在室温和冷藏保存48h时,两者的MCV差异有统计学意义(P<0.05)。结论在室间以及在不同温度保存的条件下,MCH指标较MCV重复性好且更稳定,MCH指标作为临床一线地贫筛查指标比MCV指标更可靠。Objective To compare the reliability of erythrocyte parameter mean corpuscular volume（MCV）and mean corpuscu-lar hemoglobin（MCH）for screening thalassaemia trait.Methods A fresh venous blood sample with the cut-off value of MCV was sent to 21 hospitals of Zhuhai city for conduct the full blood cell analysis within 1 d.Then the inter-and intra-coefficient of varia-tion （CV）as well as bias values of MCV and MCH were calculated and compared.In addition,10 EDTA-anticoagulant venous blood samples were divided into two parts,the effects of stored temperature and time on MCV and MCH were observed.Results The coefficient of variation（CV）of MCV （4.1%）was significantly greater than that of MCH （2.8%）among 21 laboratories,the qualification rate of MCH detection results was 100%,which was significantly higher than 66.7% of MCV （P 〈0.05）.When the whole blood samples were stored under 2 kinds of the temperature condition（room temperature and refrigeration）for 72 h,MCH changed little （P 〉0.05）.When these samples were stored under the refrigerated condition for 72 h,MCV had no statistically sig-nificant difference compared with the instant detection results of MCV （P 〉0.05）,when stored at the room temperature for 48 h, MCV was significantly increased （P 〈0.05）,MCV had statistical difference in storage for 48 h between the room temperature and the refrigeration.Conclusion Among laboratories and under different temperature conditions,the reproducibility of MCH is better than that of MCV and is more stable than MCV.MCH as the clinical first-line screening for thalassaemia is more reliable than MCV.

关 键 词：地中海贫血 筛查 红细胞平均体积 红细胞平均血红蛋白 

分 类 号：R556[医药卫生—血液循环系统疾病]