平均红细胞体积与平均红细胞血红蛋白联合筛查妊娠孕妇地中海贫血诊断效果分析

目的探讨平均红细胞体积(Mean corpuscular volume,MCV)与平均红细胞血红蛋白含量(Mean corpuscular hemoglobin,MCH)联合筛查诊断妊娠期地中海贫血的效果。方法选取67例地贫妊娠期孕妇作为病例组和同期健康检查的242例妊娠孕妇作为正常组,比较地贫组和正常组的MCV、MCH、平均血红蛋白浓度(MCHC)、红细胞分布宽度标准差(RDW-SD)的差异,分析MCV、MCH、MCHC、RDW-SD、MCV+MCH筛查妊娠期地贫的灵敏度、特异度及准确度。结果贫血组的血红蛋白、MCV、MCH、MCHC、RDW-SD等指标含量均明显低于正常组(P<0.01);MCV联合MCH筛查地贫的灵敏度、特异度、准确度分别高达95.5%、95.0%、95.1%。结论 MCV、MCH对于妊娠期地贫的筛查具有更高的灵敏度和特异度,而MCV和MCH联合筛查效果更好。     

产前生化筛查检验对地中海贫血的临床价值分析

目的:评价产前生化筛查检验对地中海贫血的临床价值。方法:2013年9月~2015年9月,医院产科门诊共收治婴儿地贫68例,同期目前诊断为β地贫基因阳性578例,α地贫基因阳性914例,取同期正常孕妇500例。结果:正常孕妇与α地贫基因阳性孕妇、β地贫基因阳性孕妇、娩出地贫儿孕妇Hb、MCH、RBC、MCV、RDW、HbA2差异具有统计学意义(P0.05);娩出地贫儿孕妇与α地贫基因阳性孕妇、β地贫基因阳性孕妇Hb、MCH、RBC、MCV、RDW、HbA2差异具有统计学意义(P0.05);血常规与红细胞脆性检查阳性率58.56%、血红蛋白电泳阳性50.92%(1382/2714),检出胎婴儿地贫84例,活产66例,占97.06%。结论:分层产前生化筛查检测可检出绝大多数地中海贫血胎儿。     

MCH、MCV及RDW检测在缺铁性贫血与地中海贫血鉴别诊断中的价值分析

目的:分析平均红细胞含量(MCH)、平均红细胞体积(MCV)及红细胞体积分布宽度(RDW)检测在缺铁性贫血(IDA)与地中海贫血鉴别诊断中的价值。方法:选择2018年1月～2019年12月某院收治的68例IDA患者并作为IDA组,70例地中海贫血患者作为地贫组,同时选取同期体检健康者70例作为对照组。采集入选者空腹静脉血,通过全自动血细胞分析仪测定MCH、MCV及RDW水平,比较3组MCH、MCV及RDW水平,以地贫基因检测结果作为金标准,计算MCH、MCV及RDW联合鉴别诊断地中海贫血的敏感度、特异度。结果:IDA组MCH水平地贫组对照组,地贫组MCV水平IDA组对照组,IDA组RDW水平地贫组对照组,差异有统计学意义(P0.05);以地贫基因检测结果作为金标准,MCH、MCV及RDW联合诊断地中海贫血的敏感度为90.00%,特异度为91.18%。结论:MCH、MCV及RDW联合检测在贫血诊断中具有重要意义,能够为临床鉴别诊断不同类型贫血类型提供依据,指导临床针对性治疗。     

观察产前筛查地中海贫血中MCV和RBC脆性及血红蛋白电泳的应用

目的:观察临床采用MCV(平均红细胞体积,mean corpuscular volume)和RBC(红细胞,Erythrocytes)脆性及Hb(血红蛋白,hemoglobin)电泳进行产前筛查地中海贫血的临床价值。方法:选取2016年1月~2017年3月期间于某院行产前检查通过基因诊断后确诊的300例地中海贫血孕妇设为试验组,另选取同期于某院行产前检查的非地贫孕妇300例设为对照组,均测定两组MCV,行RBC与Hb电泳试验,对单项及3项试验结果进行对比分析,并对3项试验检测地中海贫血的特异度、灵敏度等进行评价。结果:地贫筛选过程中MCV特异性相对于RBC脆性、Hb电泳较低,但Hb电泳、RBC脆性的灵敏度相抵偏低;各试验平行联合检测的灵敏度、阴性预测值均相对得到了提高,但降低了特异度、阳性预测值;系列联合检测则对于特异度、阳性预测值有提高效果,但是降低了灵敏度、阴性预测值;平行检测与单项检测比较其灵敏度、阴性预测值得到明显提高(P<0.05),系列检测与单项检测比较其特异度、阳性预测值得到明显提高(P<0.05)。结论:MCV、RBC脆性及Hb电泳3项联合检测筛查地贫效果较佳,优于单项检测,值得临床推广应用。     

β地中海贫血基因携带者及G6PD缺乏的产前筛查与血液学指标评价

目的调查本地区围生期妇女β地中海贫血(地贫)基因携带率和G6PD缺乏的发病率;以及评价血液学指标在β地贫及G6PD酶缺乏筛查中的意义.方法对产前检查的孕妇,进行了β地贫基因诊断及G6PD定量分析,血常规红细胞参数检测及血红蛋白电泳HbA2定量.对已明确诊断的85例β地贫组,76例IDA组及75例G6PD酶缺乏组,进行红细胞参数(RBC、Hb、HCT、MCV、MCH、MCHC、RDW、RET)结果的比较;并将各方法检测结果与地中海贫血基因诊断结果比较,分析各筛查方法的敏感性和特异性.结果2 450例孕妇共检出β地贫阳性85例,β地贫基因携带率为3.5%;共检出G6PD缺乏75例,G6PD缺乏的发病率为3.1%.地贫组、IDA组及G6PD缺乏组RET均增高,与正常对照组比较,差异均有显著性(P＜0.01);G6PD缺乏组RET显著增高,与地贫组及IDA组比较,差异均有显著性(P＜0.01).在地贫组和IDA组中,MCV均减低,RDW均增高,与正常对照组比较,均有显著性差异(P＜0.01).地贫组与IDA组比较,地贫组MCV减低较IDA组明显,两者之间差异有显著性(P＜0.01).对照基因检测结果,MCV诊断地贫基因携带者的敏感性为97.6%,特异性为54.5%.HbA2定量对β地贫基因携带者的敏感性为96.8%,特异性为97.4%.结论CD41-42(-CTTT)是本地区孕妇最常见的β地贫基因突变类型,MCV测定可作为产前地贫携带者筛查的敏感而有价值指标,而HbA2定量是β地贫基因携带者筛查可靠的血液学指标.     

MCV、MCH、RDW及SF在贫血鉴别诊断中的应用价值分析

目的:分析平均红细胞体积(MCV)、平均红细胞血红蛋白量(MCH)、红细胞分布宽度(RDW)及血清铁蛋白(SF)在贫血鉴别诊断中的应用价值。方法:选取2016年7月～2018年4月经基因诊断明确为地中海贫血的女性120例作为地贫组,选取同期检查的缺铁性贫血女性100例作为IDA组,另选取同期进行健康体检的女性80例作为对照组,探究MCV、MCH、RDW、SF联合检测在筛查地中海贫血基因中的应用价值。结果:120例地中海贫血患者中55例为α-地中海贫血,65例为β-地中海贫血;地贫组与IDA组MCV及MCH水平均低于对照组,地贫组SF水平高于IDA组及对照组,IDA组RDW水平均高于地贫组与对照组,差异有统计学意义(P0.05);采用MCV、MCH、RDW、SF联合检测灵敏度为91.67%、特异度为90.00%、准确度为90.91%。结论:MCV、MCH、RDW及SF检测可有效提高贫血鉴别诊断准确率,对预防及减少重型地贫患儿的出生具有重要价值。     

梅毒血清学检测方法的选择与产前常规筛查中的应用分析

目的研究并探讨不同梅毒血清检测方法在产前梅毒常规筛查中的应用效果。方法于2014年1月~2015年6月,选取在我院进行产前梅毒常规筛查的500例孕妇进行研究,分别采用梅毒螺旋体明胶凝集试验(TPPA法)、免疫胶体金法、甲苯胺红不加热血清反应素试验(TRUST法)对梅毒进行检测,对比TPPA法、免疫胶体金法、TRUST法、三种方法联合检测的敏感度、特异度、准确性、阳性预测值以及阴性预测值。结果 500例进行产前梅毒常规筛查的孕妇中,有448例孕妇被确诊为梅毒阳性,52例孕妇为阴性。三种梅毒血清学检测方法的敏感度、特异度、准确性、阳性预测值以及阴性预测值均不存在统计学差异(P>0.05),但三种检测方法联合检测的敏感度、特异度、准确性、阳性预测值以及阴性预测值均明显高于单一的检测方法(P<0.05)。结论在产前梅毒筛查中,TPPA法、TRUST法以及胶体金法具有其各自的优势,三种方法进行联合检测可提高梅毒检出率,产前梅毒筛查时可进行联合检测。     

孕妇地中海贫血的临床血液学指标分析

目的:探讨孕妇地中海贫血的血液学指标包括平均红细胞体积(MCV)、HbA2、红细胞脆性对孕妇地中海贫血的诊断价值。方法:以北京大学深圳医院93名正常孕妇,141名地贫孕妇,104名地贫非孕妇为研究对象,对基因确诊的地贫孕妇、地贫非孕妇和健康孕妇进行血常规,红细胞脆性,血红蛋白电泳等检查,分析MCV、HbA2、红细胞脆性血液学指标,评价其筛查孕妇地贫的诊断价值。结结结果:果:果:地贫孕妇的MCV、脆性与正常孕妇相比有显著差异,均明显降低(P0.05)。β-地贫孕妇HbA2明显高于正常孕妇;正常孕妇与正常非孕妇MCV、HbA2、脆性无显著差异(P0.05);α-地贫孕妇的MCV、HbA2高于α-地贫非孕妇,(P0.05)。β-地贫孕妇的HbA2低于β-地贫非孕妇(P0.05)。结结结论:论:论:地贫孕妇的MCV,HbA2与地贫非孕妇存在差异,掌握孕妇MCV、HbA2的血液学指标的特点有助于更准确地筛查妊娠合并地中海贫血。     

红细胞参数在孕检人员筛查地中海贫血的应用分析

目的探析红细胞参数在孕检人员筛查地中海贫血的应用价值。方法选取2015年6月~2017年6月到我院接受孕检的300例孕检人员为主要研究对象,采用全自动血液分析仪对孕检人员的红细胞参数进行测定,分析其地中海贫血基因,对孕检人员的各项红细胞参数检测结果以及最终的筛查诊断结果进行回顾性分析。结果 300例孕检人员中,地中海贫血检测阳性165例(观察组),地中海贫血检测阴性135例(对照组)。观察组研究对象的红细胞平均体积(MCV)、平均红细胞血红蛋白量(MCH)均明显低于对照组,观察组的红细胞分布宽度变异系数(RDW-CV)高于对照组,两组之间的红细胞参数检测值比较差异有统计学意义(P0.05)。红细胞参数检测和基因诊断在地中海贫血与非地中海贫血研究对象上的诊断准确率比较差异无统计学意义(P0.05)。结论在孕检时采用检测红细胞参数的方式筛查地中海贫血,是一种经济、有效的筛查方法,可根据各项红细胞参数值判断是否患有地中海贫血,提升孕检效率。     

利用血常规中红细胞体积分布宽度筛查方法鉴别诊断缺铁性贫血和地中海贫血的临床价值研究

目的研究分析血常规中红细胞体积(MCV)、红细胞分布宽度(RDW)在鉴别诊断缺铁性贫血(IDA)和地中海贫血中的应用价值。方法研究病例来自于我院2016年4月～2017年4月期间接诊的78例贫血患者,入选患者均进行血常规检测,其中IDA45例,地中海贫血33例,另选取同期在我院进行健康体检的40例患者作为对照,观察分析三组患者MCV、RDW水平之间的差异,计算IDA组和地中海贫血组检测的特异度和灵敏度。结果地中海贫血组、IDA组、对照组成员MCV、RDW水平比较,差异均有统计学意义(P<0.05);根据血红蛋白电池分析结果分Hb-H组,β轻型地贫,β中间型地贫,β重型地贫,四组患者MCV、RDW水平比较,差异有统计学意义(P<0.05)。结论对贫血患者血常规进行MCV和RDW的筛查,有助于临床鉴别诊断缺铁性贫血和地中海贫血。     

CD-3200型血液分析仪在不同平均红细胞体积患者中的应用价值

目的探讨CD-3200型血液分析仪在不同平均红细胞体积患者中的应用价值。方法选择40例MCV正常患者与40例MCV〈80fl患者,均使用CD-3200型机器与手工显微镜进行检测,比较不同MCV患者血小板计数结果,并计算RBC与PLT比率总均值。结果机器法所得血小板计数以及RBC与PLT比率总均值在两组中均大于显微镜法（P〈0.05）,且在MCV小于80fl的患者中,机器法和显微镜法所得血小板计数多于MCV正常组（P〈0.05）,所得RBC与PLT比率总均值均小于MCV正常组（P〈0.05）。结论 CD-3200型血液分析仪检测血小板计数,受到患者MCV的影响较为明显,临床工作中必要时需要通过手工检测进行校准。     

血尿患者自身血和尿平均红细胞容积及其比值在血尿来源鉴别中的价值

目的探讨以测定血尿患者自身血和尿平均红细胞容积(MCV)及其比值来鉴别肾小球性血尿与非肾小球性血尿的临床意义。方法 应用MEK-8222K血细胞分析仪对200例血尿患者(肾小球性血尿患者102例设为观察组,非肾小球性血尿患者98例设为对照组)进行自身血和尿MCV测定,然后比较分析2组检测结果。结果 观察组尿MCV值低于对照组,差异有统计学意义(P<0.01)。且观察组血和尿MCV比值高于对照组,差异有统计学意义(P<0.05)。尿MCV<75fl,自身血和尿MCV比值>1.4,诊断肾小球性血尿符合率为97.1%;尿MCV≥75fl,自身血和尿MCV比值≤1.1,诊断非肾小球性血尿符合率为96.9%。结论 测定血尿患者自身血和尿MCV及其比值,是一种客观、无创伤的鉴别血尿来源的方法。     

Capecitabine treatment results in increased mean corpuscular volume of red blood cells in patients with advanced solid malignancies

Capecitabine is a novel fluoropyrimidine carbamate which is selectively activated after oral administration to 5-fluorouracil (5-FU) by a sequential triple enzyme pathway in liver and tumor cells. The cytotoxic activity of the metabolized 5-FU depends on thymidylate synthase (TS) inhibition, leading to defective DNA synthesis. Capecitabine has shown promising activity in all tumor types sensitive to 5-FU and is therefore investigated in many clinical trials. Since we observed an increase of mean corpuscular volume (MCV) of red blood cells under therapy with capecitabine, the current investigation aimed to quantitate this effect and to elucidate the underlying mechanisms. A total of 154 patients suffering from advanced cancer received capecitabine (2500 mg/m2/day for 14 days every 21 days) either as monotherapy, or in combination with other antineoplastic agents or biological response modifiers. During 3 consecutive cycles of therapy a complete blood cell count including the red cell indices MCV, mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration was performed before each application of capecitabine. In addition, vitamin B12, folic acid and homocysteine were determined to define their role in increasing MCV. Restaging was performed after 9 weeks. Within 9 weeks, a statistically significant increase of MCV (without other hematologic abnormalities or clinical symptoms) could be observed (p<0.0001). Vitamin B12, folic acid and homocysteine levels did not change significantly during the observation period. When comparing the different increases of MCV during 9 weeks (deltaMCV) with respect to tumor response, deltaMCV tended to higher values in patients with tumor remission or stable disease than in patients with tumor progression. We conclude that serum levels within the normal range rule out severe deficiencies of vitamin B12, folic acid or homocysteine as an account of macrocytemia. We therefore hypothesize that an increased MCV (without concomitant anemia) in patients receiving capecitabine might be due to the 5-FU-induced TS inhibition also in erythroid precursor cells. Whether this increase in MCV might serve as a surrogate marker for tumor response has to be evaluated in further investigations.     

XE-5000血细胞分析仪MCV和RDW对血小板测定的影响

目的讨论平均红细胞体积（MCV）和红细胞分布宽度（RDW）对SysmexXE-5000血细胞分析仪检测血小板（PIJT）的影响。方法采用XE-5000血细胞分析仪对处于不同范围内平均红细胞体积的样本进行分组,并分别用电阻抗法和荧光法进行血小板计数,其值分别为（PLT—I）和（PLT—O）,两者的血小板数相比较,再将数据进行统计学分析。结果MCV≥80fL时,电阻法和光学法血小板测定结果差异无统计学意义（P〉0．05）;70fL≤MCV〈80fL时,电阻法和光学法血小板测定仍差异无统计学意义（P〉0．05）;MCV〈70f1J时,电阻抗法和荧光法血小板测定差异有统计学意义（P〈0．05）;当70fL≤MCV〈80fL、RDW〉0．15时,电阻抗法和荧光法血小板测定差异有统计学意义（P〈O．05）;当RDW〈0．15时电阻法和光学法血小板测定结果差异无统计学意义（P〉0．05）。结论当MCV〈70fL或者70fL≤MCV〈80tL、RDW〉0．15时,血小板应该采用光学法检测以获得较为准确的数据。     

Effectiveness of the CAGE questionnaire, gamma-glutamyltransferase and mean corpuscular volume of red blood cells as markers for alcohol-related problems in the workplace

OBJECTIVE: To evaluate the usefulness of gamma-glutamyltransferase (GGT) and mean corpuscular volume (MCV), as well as that of the CAGE questionnaire, in workplace screening for alcohol abuse/dependence. METHODS: A total of 183 male employees were submitted to structured interviews (Structured Clinical Interview for DSM-IV 2.0 and CAGE questionnaire). Blood samples were collected. Diagnostic accuracy and odds ratio were determined for the CAGE, GGT and MCV. RESULTS: The CAGE questionnaire presented the best sensitivity for alcohol dependence (91%; specificity, 87.8%) and for alcohol abuse (87.5%, specificity, 80.9%), which increased when the questionnaire was used in combination with GGT (sensitivity, 100% and 87.5%, respectively; specificity, 68% and 61.5, respectively). CAGE positive results and/or alterations in GGT were less likely to occur among employees not presenting alcohol abuse/dependence than among those presenting such abuse (OR for CAGE=13, p<0.05; OR for CAGE-GGT=11, p<0.05) or dependence (OR for CAGE=76, p<0.01; OR for GGT=5, p<0.01). Employees not presenting alcohol abuse/dependence were also several times more likely to present negative CAGE or GGT results. CONCLUSIONS: The use short, simple questionnaires, combined with that of low-cost biochemical markers, such as GGT, can serve as an initial screening for alcohol-related problems, especially for employees in hazardous occupations. The data provided can serve to corroborate clinical findings.     

尿红细胞MCV与RDW测定鉴别血尿来源的性质

目的探讨尿红细胞平均体积（MCV）与红细胞体积分布宽度（RDW）测定在血尿来源诊断中的价值。方法应用SYsmex XE-2100血细胞分析仪测定4O例。肾小球性血尿患者与36例非肾小球性血尿患者的MCV与RDW。结果’肾小球性血尿MCV明显低于非。肾小球性血尿,有显著性差异。肾小球性血尿的RDW明显高于非肾小球性血尿,有显著性差异。结论使用血细胞分析仪测定尿中红细胞MCV及RDW对血尿来源诊断有一定的价值。     

Combinations of carbohydrate-deficient transferrin, mean corpuscular erythrocyte volume, gamma-glutamyltransferase, homocysteine and folate increase the significance of biological markers in alcohol dependent patients

AIMS: The traditionally used biological markers for alcoholism include a wide range of sensitivity and specificity as single tests. This study focuses on the combination of established laboratory parameters with new meaningful biomarkers to advance the significance regarding alcohol dependence. DESIGN: We analyzed blood samples from alcohol-dependent patients (n=177) compared with a control group (n=181). In the statistical calculation we included carbohydrate-deficient transferrin (CDT), mean corpuscular erythrocyte volume (MCV), gamma-glutamyltransferase (GGT), total plasma homocysteine, and folate. RESULTS: None of the examined biomarkers reached sensitivity above 90% while all markers showed a good specificity. Combinations of different markers led to a significant elevation in sensitivity. Best values for men were achieved by using a combination of MCV, CDT, GGT, homocysteine and folate in different weightings (sensitivity: 98.6%, specificity: 86.4%). For women, similar results were yielded by combining MCV and CDT (sensitivity: 94.1%, specificity: 96%). The addition of homocysteine and folate in different weightings did not result in further enhancement. CONCLUSIONS: Gender-specific clusters including MCV, CDT, GGT, homocysteine and folate led to an increase in sensitivity compared to single laboratory markers. This is a reliable help to identify patients with regular heavy drinking in clinical practice which might prevent further complications.