儿童地中海贫血红细胞相关参数特征及其筛查意义  

Characteristics of red blood cell related parameters in children with thalassemia and the screening significance

作　　者：程昭科 王敏洁 陈丹虹 CHENG Zhao-ke;WANG Min-jie;CHEN Dan-hong(Department of Clinical Laboratory,Guangning County People's Hospital,Zhaoqing 526300,Guangdong,CHINA)

机构地区：[1]肇庆市广宁县人民医院检验科,广东肇庆526300

出　　处：《海南医学》2020年第17期2229-2232,共4页Hainan Medical Journal

基　　金：广东省肇庆市科技创新指导类项目(编号:202004031464)。

摘　　要：目的分析儿童地中海贫血红细胞相关参数的特征及其筛查意义。方法选择2017年2月至2019年2月肇庆市广宁县人民医院收治的340例地中海贫血患儿为观察组,200例健康儿童为对照组,检测并比较两组儿童外周静脉血红细胞计数(RBC)、血红蛋白(HGB)、红细胞平均体积(MCV)、平均红细胞血红蛋白量(MCH)、红细胞体积分布宽度(RDW)、血红蛋白A2(HbA2)的差异,同时比较不同性别、基因分型地中海贫血患儿上述参数的差异,采用受试者工作特征曲线(ROC)探讨其筛查价值。结果观察组患儿的HGB、MCV、MCH明显低于对照组,RDW、HbA2明显高于对照组,差异均有统计学意义(P<0.05);不同性别地中海贫血患儿的红细胞参数比较差异均无统计学意义(P>0.05);β型地中海贫血患儿的MCH、RDW、HbA2明显高于α型地中海贫血患儿,差异均有统计学意义(P<0.05);MCV、MCH、RDW、HbA2诊断地中海贫血的灵敏度分别为91.76%、94.12%、72.94%、77.65%,特异度分别为62.00%、58.00%、72.00%、84.00%,曲线下面积(AUC)分别为0.788、0.733、0.686、0.705,而联合MCV、MCH、RDW、HbA2诊断地中海贫血的灵敏度和特异度分别为97.65%、98.00%。结论红细胞相关参数对地中海贫血患儿筛查价值较高,其中患儿MCV、MCH、RDW、HbA2参数存在明显异常,而β型地中海贫血患儿MCH、RDW、HbA2改变更显著。Objective To analyze the characteristics of red blood cell related parameters of thalassemia in children and its screening significance.Methods A total of 340 children with thalassemia in Guangning County People's Hospital from February 2017 to February 2019 were selected as the observation group,and 200 healthy children were selected as the control group.The differences of red blood cell(RBC),haemoglobin(HGB),mean corpuscular volume(MCV),mean corpuscular hemoglobin(MCH),red cell distribution width(RDW),and hemoglobin A2(HBA2)were detected and compared between the two groups,and also between different genders and genotypes of thalassemia.The screening value was explored by receiver operating characteristic curve(ROC).Results HGB,MCV,and MCH in the observation group were significantly lower than those in the control group,while RDW and HBA2 were significantly higher than those in the control group(P<0.05).MCH,RDW,and HBA2 ofβ-thalassemia were significantly higher than those ofα-thalassemia(P<0.05).The sensitivity of MCV,MCH,RDW,and HBA2 in the diagnosis of thalassemia was 91.76%,94.12%,72.94%,and 77.65%,respectively,the specificity was 62.00%,58.00%,72.00%and 84.00%,and the area under curve(AUC)was 0.788,0.733,0.686,and 0.705,respectively.The sensitivity and specificity of combined detection of MCV,MCH,RDW,and HBA2 were 97.65%and 98.00%,respectively.Conclusion The parameters of MCV,MCH,RDW,and HBA2 were abnormal in children with thalassemia,but the changes of MCH,RDW and HBA2 were more significant in children withβthalassemia.

关 键 词：红细胞 地中海贫血 红细胞平均体积 血红蛋白 红细胞体积分布宽度 血红蛋白A2 筛查 

分 类 号：R725.5[医药卫生—儿科]