血红蛋白A2和胎儿血红蛋白联合检测在儿童β-地中海贫血筛查中的应用价值  

Application values of combined use of hemoglobin A2 and fetal hemoglobin in the screening of β-thalassemia in children

作　　者：常剑锋[1] 罗宇婷 陈莉 CHANG Jian-feng;LUO Yu-ting;CHEN Li(Department of Clinical Laboratory,the Second People′s Hospital of Zhaoqing City,Guangdong Province,Zhaoqing 526060,China)

机构地区：[1]广东省肇庆市第二人民医院检验科,广东肇庆526060

出　　处：《中国当代医药》2018年第18期115-117,共3页China Modern Medicine

摘　　要：目的探讨血红蛋白A2(HbA2)和胎儿血红蛋白(Hb F)联合检测在儿童β-地中海贫血(β-地贫)筛查中的应用价值。方法选择2015年1月~2017年10月我院收治的48例β-地贫患儿为实验组,选同期于我院体检的50例健康儿童作为参照组。观察比较两组血浆中HbA2和Hb F含量,以基因检测结果为金标准,利用受试者工作特征(ROC)曲线分析比较HbA2、Hb F及两者联合曲线下面积(AUC)、最适界值点(cutoff值)、敏感度及特异度,并采用Logistic回归分析HbA2和Hb F对β-地贫患儿的诊断价值。结果实验组血清的HbA2和Hb F含量分别为(5.12±0.65)%和(1.27±0.86)%,明显高于参照组的(2.63±0.76)%和(0.49±0.38)%,差异均有统计学意义(P<0.05)。HbA2、Hb F及两者联合的AUC分别为0.923、0.896和0.954,其中HbA2和Hb F的cutoff值分别为3.5%和0.6%,两者联合诊断的灵敏度和特异度分别为97.92%和86.00%。二分类Logistic回归分析结果表明,HbA2和Hb F指标对诊断β-地贫患儿均有统计学意义(P<0.05),且HbA2的诊断价值显著>Hb F。结论 HbA2和Hb F指标检测在儿童β-地贫筛查中均具有一定的应用价值,且HbA2的诊断价值明显优于Hb F,两者联合诊断可大大提高诊断符合率。Objective To investigate the value of combined detection of hemoglobin A2(HbA2)and fetal hemoglobin(HbF)in the screening ofβ-thalassemia in children.Methods A total of 48 children withβ-thalassemia admitted in our hospital from January 2015 to October 2017 were selected as the experimental group and 50 healthy children undergoing physical examination in our hospital as the reference group.The levels of HbA2 and HbF in the two groups were observed and compared.The gene test results were taken as the gold standard and used the ROC curve to compare HbA2,HbF and the area under the curve(AUC),cutoff value,sensitivity and specificity,and used the Logistic regression to analysis HbA2 and HbF in children withβ-thalassemia diagnostic value.Results.The levels of HbA2 and HbF in the experimental group were(5.12±0.65)%and(1.27±0.86)%,which were significantly higher than those in the reference group(2.63±0.76)%and(0.49±0.38)%,respectively(P<0.05).The AUC of HbA2,HbF and their combination were 0.923,0.896 and 0.954,respectively and the cutoff values of them were 3.5%and 0.6%respectively.The diagnostic sensitivity and specificity of HbA2 and HbF joint diagnosis were 97.92%and 86.00%respectively.Logistic regression analysis showed that both HbA2 and HbF were statistically significant in diagnosingβ-thalassemia children(P<0.05),and the diagnostic value of HbA2 was significantly higher than that of HbF.Conclusion Detection of HbA2 and HbF in children withβ-thalassemia screening has a certain value,and the diagnostic value of HbA2 was significantly better than HbF,a combination of the two can greatly improve the diagnostic accuracy.

关 键 词：Β-地中海贫血 HBA2 HBF 患儿 诊断 

分 类 号：R556.61[医药卫生—血液循环系统疾病]