红细胞平均体积筛查方法在地中海贫血诊断中的应用价值  

Application value of the mean corpuscular volume screening in the diagnosis of thalassemia

作　　者：罗志粦 LUO Zhi-lin(Department of Clinical Laboratory,the First Hospital of Putian City,Fujian Province,Putian351100,China)

机构地区：[1]福建省莆田市第一医院检验科

出　　处：《中国当代医药》2019年第33期162-164,168,共4页China Modern Medicine

摘　　要：目的研究红细胞平均体积(MCV)筛查方法在地中海贫血诊断中的应用价值。方法选取2017年6月~2018年6月在我院进行婚检、产检和健康体检的194例人员作为研究对象,其中经基因确诊为地中海贫血的患者158例,非地中海贫血人员36例,所有人员均接受MCV、红细胞脆性试验、血红蛋白(Hb)电泳分析等检测方法进行检测。分析MCV、红细胞脆性试验、Hb电泳检测结果以及MCV、红细胞脆性试验、Hb电泳检测的灵敏度和特异度。结果MCV检测对α地中海贫血的阳性检出率为95.51%,高于红细胞脆性试验检测(82.02%)和Hb电泳检测(69.66%),差异有统计学意义(P<0.05)。红细胞脆性试验检测对α地中海贫血的阳性检出率高于Hb电泳检测,差异有统计学意义(P<0.05)。MCV、红细胞脆性试验、Hb电泳检测对β地中海贫血、α合并β地中海贫血、非地中海贫血的阳性检出率比较,差异均无统计学意义(P>0.05);MCV检测对地中海贫血检测的灵敏度(96.65%)和特异度(87.87%),与红细胞脆性试验检测(97.16%,60.37%)及Hb电泳检测(98.48%,54.84%)比较,差异有统计学意义(P<0.05),红细胞脆性试验检测与Hb电泳检测的灵敏度、特异度比较,差异无统计学意义(P>0.05)。结论MCV对地中海贫血的阳性检出率和灵敏度较高,可作为疾病筛查的首选方法,值得推广应用。Objective To study the application value of the mean corpuscular volume(MCV)screening in the diagnosis of thalassemia.Methods From June 2017 to June 2018,a total of 194 patients who underwent premarital check-up,antenatal care,and physical examination in our hospital were selected as subjects.Among them,158 patients with thalassemia were diagnosed by gene,and 36 participants were diagnosed as non-thalassemia.All participants were tested by MCV,erythrocyte fragility test,and hemoglobin(Hb)electrophoresis analysis.The results of MCV,erythrocyte fragility test,Hb electrophoresis and their sensitivity and specificity were analyzed.Results The positive detection rate ofαthalassemia in MCV was 95.51%,which was higher than that of erythrocyte fragility test(82.02%)and Hb electrophoresis(69.66%)with statistical significance(P<0.05).The positive detection rate ofαthalassemia by erythrocyte fragility test was higher than that of Hb electrophoresis(P<0.05).There were no statistical differences in the positive detection rates of MCV,erythrocyte fragility test and Hb electrophoresis detection forβthalassemia,αwithβthalassemia and non-thalassemia(P>0.05).The sensitivity and specificity of MCV detection for thalassemia were 96.65%and 87.87%,compared with erythrocyte fragility test(97.16%and 60.37%)and Hb electrophoresis(98.48%and 54.84%),the differences were statistically significant(P<0.05).There was no significant difference in the sensitivity and specificity by erythrocyte fragility test and Hb electrophoresis(P>0.05).Conclusion The positive detection rate and sensitivity of MCV to thalassemia are high,which can be considered as the first choice for disease screening and is worthy of promotion and application.

关 键 词：地中海贫血 红细胞平均体积 红细胞脆性试验 血红蛋白电泳分析 诊断 

分 类 号：R556.61[医药卫生—血液循环系统疾病]