比较两种血红蛋白A2测定方法对轻型α地中海贫血的诊断性能  

Diagnostic performances of two hemoglobin A2 assays forα-thalassemia:A comparative study

作　　者：王展强 杨华文[1] 黄基伟[1] 李亚红[1] 曹东林[1] 雷达[1] WANG Zhanqiang;YANG Huawen;HUANG Jiwei;LI Yahong;CAO Donglin;LEI Da(Department of Laboratory Medi-cine,Guangdong Second Provincial General Hospital,Guangzhou 510317,China)

机构地区：[1]广东省第二人民医院检验医学部,广州510317

出　　处：《实用医学杂志》2022年第13期1676-1679,共4页The Journal of Practical Medicine

基　　金：广州市科技计划项目资助项目(编号:202108050520130002)。

摘　　要：目的比较高效液相色谱法和毛细管区带电泳测定血红蛋白A2(hemoglobin A2,HbA2)对轻型α地贫的诊断性能。方法选取2019年1月到2021年12月在广东省第二人民医院进行α地贫筛查的患者纳入研究,收集所有患者HbA2和地贫基因结果等临床信息,根据地贫基因结果分为对照组和轻型α地贫组,分析不同组间上述指标的差异,使用ROC曲线评价并比较高效液相色谱法和毛细管区带电泳检测HbA2对轻型α地贫的诊断性能及截断值。结果与对照组相比,轻型α地贫组的HbA2在高效液相色谱法[(2.78±0.39)%vs.(2.57±0.21)%,P<0.001)]和毛细管区带电泳[(2.62±0.46)%vs.(2.34±0.31)%,P<0.001)]检测的人群中均降低。使用高效液相色谱法检测HbA2时,其诊断轻型α地贫ROC曲线的AUC为0.715(95%CI:0.682~0.747,P<0.001),截断值为2.8%,对应的灵敏度和特异度分别为82.6%和55.7%;使用毛细管区带电泳检测HbA2时,其诊断轻型α地贫ROC曲线的AUC为0.786(95%CI:0.751~0.821,P<0.001),截断值为2.6%,对应的灵敏度和特异度分别为91.1%和57.4%。结论毛细管区带电泳检测HbA2对轻型α地贫的诊断性能优于高效液相色谱法。Objective To compare the diagnostic performances of high performance liquid chromatography and capillary zone electrophoresis in the determination of HbA2 inα-thalassemia.Methods The patients underwentα-thalassemia screening in the Guangdong Second Provincial General Hospital from January 2019 to December 2021 were engaged in this study for the gathering of their clinical data such as HbA2 and thalassemia gene test results.The patients were divided into control group andα-thalassemia group according to the results of thalassemia gene detection.The indexes of the two groups were analyzed.The ROC was used to evaluate and compare the diagnostic performances and cut-off point of HbA2 inα-thalassemia detected by high performance liquid chromatography and capillary zone electrophoresis.Results HbA2 in theα-thalassemia group was both significantly decreased when detected by both high performance liquid chromatography,as compared to the control group[(2.78±0.39)%vs.(2.57±0.21)%,P<0.001)]or capillary zone electrophoresis[(2.62±0.46)%vs.(2.34±0.31)%,P<0.001)].When detected by high performance liquid chromatography,the AUC of the HbA2 of ROC was 0.715(95%CI:0.682~0.747,P<0.001)and the cut-off point was 2.8%,with sensitivity and specificity of 82.6%and 55.7%,respectively,while detected by capillary zone electrophoresis,the AUC of the HbA2 of ROC was 0.786(95%CI:0.751~0.821,P<0.001)and the cut-off point was 2.6%,with sensitivity and specificity of91.1%and 57.4%,respectively.Conclusions The capillary zone electrophoresis is better than the high performance liquid chromatography when used for diagnosingα-thalassemia.

关 键 词：毛细管区带电泳 高效液相色谱法 血红蛋白A2 Α地中海贫血 

分 类 号：R446.112[医药卫生—诊断学]