MCV和RBC脆性及血红蛋白电泳在产前筛查地中海贫血的价值

目的评价平均红细胞体积（MCV）、红细胞（RBC）脆性试验、血红蛋白（Hb）电泳在产前筛查地中海贫血中的价值。方法选取来我院产前检查的经基因诊断确诊的地中海贫血患者140例,正常对照100例,分别进行MCV测定,RBC脆性试验和血红蛋白电泳试验,分析各单项试验及三项试验联合检测地中海贫血的灵敏度、特异度等评价指标。结果MCV、RBC脆性试验、Hb电泳单项检测对地中海贫血诊断的灵敏度及特异度分别为93.6%、89.3%、82.1%及78.0%、92%、97%;MCV与红细胞脆性及Hb电泳3项平行联合检测的灵敏度及特异度为100%、80.0%;系列联合检测的灵敏度及特异度为71.1%、100%。与各单项试验比较,平行联合检测的灵敏度高（P〈0.05）、系列联合检测的特异度高（P〈0.05）。结论MCV、RBC脆性试验及Hb电泳对产前地中海贫血筛查有较高价值,三项联合检测能更有效地筛查出地中海贫血携带者。

The value of mean corpuscular volume,red cell osmotic fragility test and hemoglobin electrophoresis for prenatal screening of thalassemia

Objective To evalue the mean corpuscular volume （MCV）, red blood cell （RBC） osmotic fragility test and hemoglobin （Hb） electrophoresis in the prenatal screening thalassemia. Methods 140 samples of thalassemia patients and 100 sampies of normal controls verified by molecular biologic technique were detected by MCV test, RBC osmotic fragility test and Hb electrophoresis. The sensitivity, specificity and other evaluation index of the single test and that of combined detection were analyzed respectively. Results The sensitivity and specificity of single test were as follow： Those of MCV were 93.6 %, and 78.0%, RBC osmotic fragility test were 89.3 %, and 92 %, Hb electmphoresis were 82.1% and 97 % 1 respectively. The sensitivity and specificity of parallel combined of MCV,RBC osmotic fragility test and Hb electrophoresis were100% ,80.0%and those of serial combined test were 71.1%, 100%. There were significant differences of sensitivity or specificity between single test and the combination of three tests （ P 〈 0.05）. Conclusion MCV, RBC osmotic fragility test and Hb eleetrophoresis are valuable for prenatal screening of thalassemia. The combination of three tests may be more valuable than single test.