MCV、MCH、RBC脆性和HbA2在广东地区α-地中海贫血筛查中的价值  

Values of MCV,MCH,ROFT and HbA2 for Screeningα-Thalassemia in Guangdong Area

作　　者：刘勇[1] 林晓英 黄燕[1] 黄倩雯 陈海雷 沈妙娜 阮嘉钰 李欣瑜[1] 许吕宏[1] 方建培[1] LIU Yong;LIN Xiao-Ying;HUANG Yan;HUANG Qian-Wen;CHEN Hai-Lei;SHEN Miao-Na;RUAN Jia-Yu;LI Xin-Yu;XU Lyu-Hong;FANG Jian-Pei(Hematologic Laboratory,Department of Pediatrics,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510120,Guangdong Province,China)

机构地区：[1]中山大学孙逸仙纪念医院儿科血液专科/儿科血液室,广东广州510120

出　　处：《中国实验血液学杂志》2020年第5期1679-1682,共4页Journal of Experimental Hematology

基　　金：国家自然科学基金项目(81370603);国家卫生和计划生育委员会临床重点学科项目(1311200006107)。

摘　　要：目的:探讨平均红细胞体积(MCV)、平均血红蛋白量(MCH)、红细胞渗透脆性试验(ROFT)和血红蛋白A2(HbA2)在广东地区筛查α-地中海贫血中的价值。方法:收集2017年1月到2017年12月于本院就诊患者外周血365例。以地中海贫血基因检测为金标准,同时进行血细胞常规分析,血红蛋白电泳测定和红细胞渗透脆性试验测定。通过受试者工作曲线(ROC曲线)确定MCV、MCH、ROFT和HbA2在α-地中海贫血中的最佳截断值。结果:α-地中海贫血基因类型以--SEA/αα最常见(54.59%)。与正常对照组相比,不同分型α-地中海贫血MCV、MCH、ROFT和HbA2的差异均有统计学意义(P<0.05)。MCV、MCH、ROFT和HbA2诊断α-地中海贫血的最佳截断值分别为81.45 fl、27.35 pg、79.95%和2.55%。结论:不同实验室应该建立适合本地区的α-地中海贫血初筛截断值。MCV、MCH、ROFT和HbA2对于诊断α-地中海贫血具有较高的准确性和灵敏度,广东地区建议使用MCV<81.45 fl、MCH<27.35 pg、ROFT<79.95%和HbA2<2.55%作为筛查α-地中海贫血的标准。Objective:To investigate the values of mean corpuscular volume(MCV),mean corpuscular hemoglobin(MCH),red cell osmotic fragility test(ROFT)and hemoglobin A2(HbA2)in screening ofα-thalassemia in Guangdong area.Methods:A total of 365 peripheral blood samples in patients treated in our hospital from January 2017 to December 2017 were collected.The detection of thalassemia gene was used as the gold standard,while blood routine examination,hemoglobin electrophoresis,and red cell osmotic fragility test were simultaneously performed.The optimal cut-off values in MCV,MCH,ROFT and HbA2 inα-thalassemia were determined by receiver operator characteristic curve(ROC curve).Results:The most common types ofα-thalassemia gene was--SEA/αα(54.59%).Compared with the control group,the differences in MCV,MCH,ROFT and HbA2 showed statistically significantce between different types ofα-thalassemia(P<0.05).The best cut-off values of MCV,MCH,ROFT,and HbA2 in the diagnosis ofα-thalassemia were 81.45 fl,27.35 pg,79.95%,and 2.55%respectively.Conclusion:For different laboratories,the cut-off values need to be established for screeningα-thalassemia suitable in their own local region.The values of MCV,MCH,ROFT and HbA2 shows higher accuracy and sensitivity in the diagnosis ofα-thalassemia.It is recommended to use MCV<81.45 fl,MCH<27.35 pg,ROFT<79.95%and HbA2<2.55%as the standards for screeningα-thalassemia in Guangdong area.

关 键 词：Α-地中海贫血 平均红细胞体积 平均红细胞血红蛋白量 红细胞渗透脆性试验 血红蛋白A2 

分 类 号：R556.6[医药卫生—血液循环系统疾病]