桂西地区珠蛋白生成障碍性贫血的红细胞参数筛查价值探讨

目的研究红细胞参数在不同类型珠蛋白生成障碍性贫血筛查中的诊断价值,为珠蛋白生成障碍性贫血患者提供敏感度和特异度高而又经济快捷的筛查方法。方法选取经我院基因诊断确诊的不同类型的珠蛋白生成障碍性贫血患者149例,正常对照51例,采用HORIBA ABX PENTRA DX 120全自动血细胞分析仪进行以下红细胞参数测定：血红蛋白（HGB）、红细胞平均体积（MCV）、红细胞平均血红蛋白含量（MCH）、红细胞平均血红蛋白浓度（MCHC）和红细胞分布宽度（RDW）,并进行分析统计。结果地贫各组红细胞参数与正常对照组比较差异均有统计学意义（P〈0.05）。HGB、MCV、MCH、MCHC和RDW筛查α、β和α＋β珠蛋白生成障碍性贫血的灵敏度分别是69.6%、83.3%和72.7%,84.8%、97.9%和100%,88.6%、100%和100%,78.5%、77.1%和77.3%,57.0%、64.6%和63.6%,HGB、MCV、MCH、MCHC、RDW筛查珠蛋白生成障碍性贫血的特异度分别是76.5%、96.1%、70.6%、49.0%和80.4%。结论红细胞参数MCV〈80 fl作为桂西地区珠蛋白生成障碍性贫血的筛查指标是最佳的。

To investigate the value of erythrocyte parameter for diagnosis of thalassemia in Guixi

Objective：To study the diagnosis value of erythrocyte parameters in different kind thalassemia,to provide a useful diagnosis method for thalassemia. Methods：Selecting 144 thalassemia patients diagnosed by polymerase chain reaction（PCR）and 51 healthy subjects,HGB,MCV,MCH,MCHC and RDW were detected by HORIBA ABX PENTRA DX 120 automatic blood cell analyzer,and the test results were analyzed. Results：There were significant differences of erythrocyte parameters between thalassemia group and control group（P0.05）. The sensitivity for screening of α,β and α＋β-thalassemia as follow：HGB 69.6%,83.3% and 72.7%,MCV 84.8%,97.9%and100%,MCH 88.6%,100% and 100%,MCHC 78.5%,77.1%and 77.3%,RDW 57.0%,64.6% and 63.6%,the specificity for screening of thalassemia as follow：HGB 76.5%,MCV 96.1%,MCH 70.6%,MCHC 49.0% and RDW 80.4%.Conclusions：The erythrocyte parameter MCV80flis a good prognostic factor for screening of thalassemia in Guixi.