毛细血管血红蛋白电泳联合血常规检测鉴别妊娠期轻型β地中海贫血与缺铁性贫血的诊断价值  

Diagnostic value of capillary hemoglobin electrophoresis detection combined with blood routine examination in distinguishing mild β-thalassemia and iron-deficiency anemia during pregnancy

作　　者：王书凯 WANG Shukai(The Third People's Hospital of Henan Province,Zhengzhou,Henan 450006,China)

机构地区：[1]河南省直第三人民医院,河南郑州450006

出　　处：《中国医学工程》2021年第3期39-43,共5页China Medical Engineering

摘　　要：目的探究毛细血管血红蛋白(Hb)电泳联合血常规检测鉴别妊娠期轻型β地中海贫血、缺铁性贫血的诊断价值。方法选取2018年1月至2019年12月在河南省直第三人民医院接受治疗的120例贫血患者,按照简单随机抽样的分组方法分为妊娠期轻型β地中海贫血组(基因诊断确诊)(β地中海贫血组)和缺铁性贫血组(骨髓穿刺涂片),每组60例。择取该院同期接受体检的自愿者60例作为健康对照组。所有对象均给予毛细血管Hb电泳检测联合血常规检查,比较3组血常规指标[红细胞平均体积(MCV)、平均红细胞血红蛋白含量(MCH)、红细胞体积分布宽度(RDW)、Hb]及毛细血管Hb电泳指标[糖化血红蛋白(HbA1c)、血红蛋白A2(HbA2)]差异,并分析其单独鉴别及联合检验对妊娠期轻型β地中海贫血、缺铁性贫血的诊断价值。结果3组MCV、MCH、RDW、Hb等血常规指标比较,差异有统计学意义(P<0.05)。3组HbA1c、HbA2水平比较,差异有统计学意义(P<0.05)。排除差异无统计学意义的两项指标,设β地中海贫血为阳性,缺铁性贫血为阴性,结果显示联合检测较单独检测HbA2、MCV、MCH、RDW指标的敏感性、特异性、准确率、阳性预测值、阴性预测值更高,分别为93.4%、94.9%、94.2%、95.0%、93.3%。结论毛细血管Hb电泳检测联合血常规较相关指标单独检测具有更好的临床诊断意义。对妊娠期轻型β地中海贫血、缺铁性贫血地鉴别有重要的价值,其准确率较高,可为临床诊断提供可靠依据。【Objective】To explore the diagnostic value of capillary hemoglobin(Hb)electrophoresis detection combined with blood routine examination in distinguishing mild β-thalassemia and iron-deficiency anemia during pregnancy.【Methods】According to the grouping method of simple random sampling,60 patients with mild β-thalassemia during pregnancy(confirmed by genetic diagnosis)(β-thalassemia group)and 60 patients with iron-deficiency anemia(bone marrow puncture smear)(iron-deficiency anemia group)who received treatment in our hospital from January 2018 to December 2019 and 60 volunteers who received health examinations during the same period(healthy control group)were selected as study subjects.All subjects were given capillary Hb electrophoresis detection combined with routine blood examination.The blood routine indicators[mean blood cell volume(MCV),mean corpuscular hemoglobin(MCH),red blood cell distribution width(RDW),Hb]and capillary Hb electrophoresis indexes[glycated hemoglobin(HbA1c),hemoglobin A2(HbA2)]were compared among the three groups of subjects,and the diagnostic value of separate identification and combined detection of mild β-thalassemia and iron-deficiency anemia during pregnancy was analyzed.【Results】There were statistically significant differences in the levels of MCV,MCH,RDW and Hb among the three groups(P<0.05).There were statistically significant differences in the levels of HbA1c and HbA2 among the three groups(P<0.05).By taking β-thalassemia as positive and iron-deficiency anemia as negative,detection results showed that the specificity,sensitivity,accuracy,positive predictive value,negative predictive value of combined detection were higher than HbA2,MCV,MCH or RDW detection alone,and the indexes were 93.4%,94.9%,94.2%,95.0% and 93.3% respectively.【Conclusion】Capillary Hb electrophoresis detection combined with blood routine examination has better clinically diagnostic significance than related indicators alone.It has important value in the differentiation of mild β-thalassemi

关 键 词：Β地中海贫血 贫血 缺铁性 电泳 诊断 

分 类 号：R447[医药卫生—诊断学]