脐血红细胞参数联合Hb电泳在β-地中海贫血中的诊断价值  

The value of the combined tests of cord blood erythrocyte parameters and hemoglobin electrophoresis for the diagnosis of β-thalassemia

作　　者：巫福娟 戴怡蘅[1] 周成[1] 李兵[2] WU Fu-juan DAI Yi-heng ZHOU Cheng LI Bing(Foshan Maternal and Children＇s Hospital, Foshan, Guangdong 528000 Guangdong Women and Children Hospital, Guangzhou, Guangdong 511400, China)

机构地区：[1]佛山市妇幼保健院,广东佛山528000 [2]广东省妇幼保健院,广东广州511400

出　　处：《热带医学杂志》2017年第10期1340-1342,共3页Journal of Tropical Medicine

摘　　要：目的探讨新生儿脐血红细胞参数及血红蛋白(Hb)电泳联合检测对β地中海贫血的诊断价值。方法选取新生儿β-地中海贫血患者508例,正常对照508名,对全部脐血样本进行β-地贫基因型、血液常规分析和血红蛋白电泳分析。用ROC曲线评价脐血各项指标或联合检测对β地中海贫血的诊断价值。结果疾病组红细胞平均容量(MCV)、平均红细胞血红蛋白量(MCH)、平均血红蛋白浓度(MCHC)、糖化血红蛋白(HbA)均低于正常对照组,血红蛋白F(HbF)高于正常对照组,差异有统计学意义(P<0.05);血液学单项指标诊断β-地中海贫血的ROC曲线下面积(AUC-ROC)由高到低依次为HbA(0.91)、HbF(0.90)、MCH(0.65)、MCV(0.61)和MCHC(0.53)。MCH、HbF、HbA联合诊断β地中海贫血的AUC-ROC为0.93(95%CI∶0.91~0.95),优于任一单项指标(P<0.05)。结论应用MCH、HbF联合HbA检测对β-地中海贫血有较高的诊断价值。Objective To investigate the value of the combined tests of cord blood erythrocyte parameters and hemoglobin electrophoresis for the diagnosis of β-thalassemia.Methods 508 neonates withβ-thalassemia and 508 cases with control group were studied.Their cord blood samples were analyzedby complete blood count and hemoglobin electrophoresis.ROC analysis was used to evaluate the diagnostic value of single and combined tests for β-thalassemia.Results In β-thalassemia patients,the values of MCV,MCH,MCHC and HbA decreased;HbF increased,which were significantly different from the control group（P〈0.05）.For single test,the AUC-ROC of HbA,HbF,MCH,MCV and MCHC from high to low was 0.91,0.90,0.65,0.61 and 0.53,respectively.Combined tests of MCH,HbF and HbA were superior to each single test with an AUC-ROC of 0.93（95%CI：0.91~0.95）.Conclusion Combined tests of cord blood MCH,HbF and HbA have high diagnostic value for β-thalassemia.

关 键 词：脐血 Β-地中海贫血 平均血红蛋白量 血红蛋白A 血红蛋白F 

分 类 号：R556.7[医药卫生—血液循环系统疾病]