血液学指标在4种常见α地中海贫血中筛查价值

潘美秀; 韦松晓; 林伟健; 李海凤

doi:10.13201/j.issn.1004-2806.2022.04.012

血液学指标在4种常见α地中海贫血中筛查价值

潘美秀¹,
韦松晓¹,
林伟健¹,
李海凤¹

- 梧州市红十字会医院检验科(广西梧州, 543002)
基金项目:
广西壮族自治区卫生健康委员会自筹经费科研课题(No: Z20190727)

详细信息

中图分类号: R556

收稿日期: 2021-07-30

修回日期: 2021-12-14

刊出日期: 2022-04-01

Screening value of hematological indexes in four types common α thalassemia

PAN Meixiu¹,
WEI Songxiao¹,
LIN Weijian¹,
LI Haifeng¹

- Department of Clinical Laboratorial Examination, Wuzhou Red Cross Hospital, Wuzhou, 543002, China

Received Date: 30 July 2021

Revised Date: 14 December 2021

Publish Date: 01 April 2022

摘要

摘要: 目的探讨平均血红蛋白量(MCH)、平均红细胞体积(MCV)、红细胞分布宽度(RDW-CV)和血红蛋白A2(HbA2)在不同基因型α地中海贫血中的筛查价值。方法收集2017年3月至2020年12月经基因检测确诊为α地中海贫血的患者560例, 根据基因型分为--^SEA/αα、-α^3.7/αα、-α^4.2/αα和--^SEA/-α^3.7 4个组, 选取同时期健康体检者300例作为对照组, 进行血细胞常规分析和血红蛋白电泳测定。通过ROC曲线确定MCH、MCV、RDW-CV和HbA2在不同基因型α地中海贫血中的最佳截断值。结果与对照组比较, 研究组MCH、MCV、RDW-CV和HbA2差异均有统计学意义(P< 0.05)；不同基因型α地中海贫血MCH、MCV、RDW-CV和HbA2比较, 差异有统计学意义(P< 0.05)。MCV诊断--^SEA/αα、-α^3.7/αα、-α^4.2/αα和--^SEA/-α^3.7地中海贫血的最佳截断值分别为78.45 fl、83.15 fl、83.45 fl、75.70 fl；MCH诊断的最佳截断值分别为24.35 pg、27.45 pg、27.65 pg、25.00 pg；RDW-CV诊断的最佳截断值分别为13.75%、12.75%、13.35%、18.70%；HbA2诊断的最佳截断值分别为2.65%、2.75%、2.95%和2.35%。结论 MCH和MCV对4种基因型地中海贫血均有较高的诊断价值, RDW-CV和HbA2诊断--^SEA/-α^3.7价值最高, 其次是-^SEA/αα, 诊断-α^3.7/αα和-α^4.2/αα价值较低。
- α地中海贫血 /
- 基因型 /
- 受试者工作曲线 /
- 血液学指标
Abstract: Objective To investigate the value expression of mean corpuscular hemoglobin(MCH), mean corpuscular volume(MCV), red blood cell distribution with(RDW-CV) and hemoglobin A2(HbA2) in α-thalassemia of different genotypes.Methods A total of 560 patients who diagnosed as α-thalassemia in our hospital from March 2017 to December 2020 were collected. They were divided into 4 groups according to the genotype: --^SEA/αα, -α^3.7/αα, -α^4.2/αα and --^SEA/-α^3.7. And 300 cases of healthy physical examination in the same period were selected as the control group. Routine blood cell analysis and hemoglobin electrophoresis were performed. The expression of MCH, MCV, RDW-CV and HbA2 in different genotypes was determined by ROC curve the best cutoff value in α-thalassemia.Results Compared with the control group, there was significant differences in MCH, MCV, RDW-CV and HbA2 in α-thalassemia group(P< 0.05). There was significant differences in MCH, MCV, RDW-CV and HbA2 in different genotypes α-thalassemia(P< 0.05). The best cutoff values of MCH for the diagnosis of thalassemia --^SEA/αα, -α^3.7/αα, -α^4.2/αα and --^SEA/-α^3.7were 24.35 pg, 27.45 pg, 27.65 pg and 25.00 pg respectively. The best cutoff values of MCV for the diagnosis of thalassemia --^SEA/αα, -α^3.7/αα, -α^4.2/αα and --^SEA/-α^3.7were79.15 fl, 84.05fl, 83.45 fl and 75.70 fl respectively. The best cutoff values of RDW-CV for the diagnosis of thalassemia --^SEA/αα, -α^3.7/αα, -α^4.2/αα and --^SEA/-α^3.7were 13.75%, 12.95%, 13.35% and 17.30% respectively. The best cutoff values of HbA2 for the diagnosis of thalassemia --^SEA/αα、-α^3.7/αα、-α^4.2/αα and --^SEA/-α^3.7were 2.65%, 2.75%, 2.95% and 2.35% respectively.Conclusion MCH and MCV have high diagnostic value on --^SEA/αα, -α^3.7/αα, -α^4.2/αα and --^SEA/-α^3.7thalassemia. The diagnostic value of RDW-CV and HbA2 was the highest on --^SEA/-α^3.7, followed by --^SEA/αα, and lower on -α^3.7/αα and -α^4.2/αα.
- α-thalassemia /
- genotypes /
- receiver operating characteristics /
- hematological indexes

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图 1 ROC曲线分析MCV、MCH和HbA2在不同基因型α地中海贫血中的价值

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图 2 ROC曲线分析RDW-CV在不同基因型α地中海贫血中的价值

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表 1 2组MCH、MCV、RDW-CV与HbA2比较 X±S

组别	MCH/pg^-	MCV/fl	RDW-CV/%	HbA2/%
对照组	28.96±1.56	86.21±1.56	12.90±0.73	2.84±0.22
研究组	21.98±3.51	70.14±8.68	15.98±3.51	2.48±0.39
差值及95%CI	6.98(6.55~7.41)	16.07(14.95~17.19)	-3.07(-3.44~2.71)	0.36(0.30~0.41)
t	31.59	28.23	-16.51	13.12
P	< 0.001	< 0.001	< 0.001	< 0.001

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表 2 MCH、MCV、RDW-CV与HbA2在不同基因型α地中海贫血中的比较 X±S

组别	MCH/pg	MCV/fl	RDW-CV/%	HbA2/%
--^SEA/αα	20.94±2.25	67.42±5.42	15.87±2.84	2.52±0.23
-α^3.7/αα	25.26±3.37	78.47±7.50	14.48±2.96	2.64±0.27
-α^4.2/αα	25.78±2.29	79.31±5.66	13.90±2.21	2.69±0.29
--^SEA/-α^3.7	17.56±2.36	59.34±8.99	22.51±2.56	1.61±0.49
F	114.86	101.32	79.27	47.78
P	< 0.001	< 0.001	< 0.001	< 0.001

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表 3 MCV、MCH、RDW-CV和HbA2指标分析不同基因型的α地中海贫血

分组指标	--^SEA/αα	-α^3.7/αα	-α^4.2/αα	--^SEA/-α^3.7
MCV/fl
曲线下面积	0.995	0.875	0.900	0.994
最佳截断值	78.450	83.150	83.450	75.700
敏感度	0.978	0.784	0.93	0.958
特异度	0.990	0.823	0.797	0.997
MCH/pg
曲线下面积	0.997	0.930	0.949	1.000
最佳截断值	24.350	27.450	27.650	25.000
敏感度	0.975	0.845	0.965	1.000
特异度	0.975	0.907	0.873	0.997
RDW-CV/%
曲线下面积	0.956	0.740	0.723	0.998
最佳截断值	13.750	12.750	13.350	18.700
敏感度	0.930	0.794	0.579	1.000
特异度	0.877	0.563	0.81	0.997
HbA2/%
曲线下面积	0.887	0.746	0.695	0.991
最佳截断值	2.650	2.750	2.950	2.350
敏感度	0.774	0.680	0.947	0.979
特异度	0.847	0.707	0.327	0.993

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参考文献(12)

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血液学指标在4种常见α地中海贫血中筛查价值

Screening value of hematological indexes in four types common α thalassemia

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血液学指标在4种常见α地中海贫血中筛查价值

Screening value of hematological indexes in four types common α thalassemia

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