地中海贫血产前筛查的循证检验

目的评价红细胞平均体积(MCV)、红细胞脆性试验和血红蛋白(Hb)电泳在地中海贫血产前筛查中的应用价值,为临床寻找一个较理想的地贫产前筛查的检验方法。方法选择2年间在我院进行系统产前检查的孕妇2060例资料,对已被基因诊断证实的210例地中海贫血孕妇的筛查实验结果进行回顾性分析。结果MCV、红细胞脆性及Hb电泳单项检测在地中海贫血产前筛查的灵敏度和特异度分别为:97.6%、89.5%、90.0%及76.0%、89.3%、97.3%;MCV与Hb电泳、红细胞脆性与Hb电泳两项平行联合检测的灵敏度及特异度分别为:100.0%、99.0%及86.7%、89.3%,系列联合检测的灵敏度及特异度分别为:89.0?.1%及99.7%、100.0%。MCV、红细胞脆性及Hb电泳三项平行联合检测的灵敏度及特异度分别为:100.0%、79.7%;三项系列联合检测的灵敏度及特异度分别为:86.7%、100.0%。经u检验,平行联合检测的灵敏度与各单项检测灵敏度之间、系列联合检测的特异度与各单项检测特异度之间差异有统计学意义(P<0.05)。结论MCV、红细胞脆性及Hb电泳三项联合检测是地中海贫血产前筛查的最理想的试验方法。

The antenatal examination of thalassemia with evidence-based laboratory

Objective: To study the value of the combined tests of mean corpuscular volume(MCV),Red Cell Osmotic fragility(RCOF) test and Hemoglobin(Hb) electrophoresis for the diagnosis of thalassemia,Antenatal examination.Methods: Selecting 2060 pregnant women datas from my hospital for this two years.Review analyzed 210 pregnant women with Thalasemia;who have diagnosed by PCR.Results: The sensitivity and specificity of single test were as follow:Those of MCV were 97.6% and 76.0% respectively.RCOF were 89.5% and 89.3%.Hb electrophoresis were 90.0% and 97.3%.The sensitivity and specificity of parallel combined test of MCV with Hb electrophoresis,RCOF with Hb electrophoresis,MCV,RCOF with Hb electrophoresis were 100.0%,99.0%,100.0% and 86.7%,89.3%,79.7% respectively.The sensitivity and specificity of serial combined of MCV with Hb electrophoresis,RCOF with Hb electrophoresis,MCV,RCOF with Hb electrophoresis were 89.0%,87.1%,86.7% and 99.7%,100.0%,100.0% respectively.There were significant differences of sensitivity or specificity between single test and the combination of three or two tests.Conclusion: The combination of MCV,RCOF with Hb electrophoresis were the best test for the diagnosis for thalassemia.antenatal examination.