红细胞平均体积和脆性及血红蛋白电泳联合检测在地中海贫血诊断中的价值

The value of the combined tests of mean corpuscular volume、 red cell osmotic fragility test and hemoglobin electrophoresis for diagnosis of thalassemia

目的 探讨红细胞平均体积(MCV)、红细胞脆性和血红蛋白 (Hb)电泳联合检测在地中海贫血诊断中的应用价值。方法 采用日本SysmexKX 21自动血细胞分析仪、中山医科大学红细胞脆性一管定量法、美国Helena公司KEP型全自动电泳分析系统,分别对确诊的 160例地中海贫血患者和110例非地中海贫血者进行MCV、红细胞脆性和Hb电泳测定,并对结果作相关统计学分析。结果 MCV、红细胞脆性、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 91. 3%、78 .1%、71 .3%及 69 .1%、90%、91. 8%;MCV与Hb电泳、红细胞脆性与Hb电泳 2项检测平行联合的灵敏度及特异度分别为 97. 5%、93 .7%及 63 6%、78 2%;系列联合的灵敏度及特异度分别为 71 2%、68 .8%及97 .3%、99 .1%。MCV、红细胞脆性、Hb电泳 3项检测平行联合的灵敏度、特异度为 100%、61 8%;系列联合的灵敏度和特异度为 67. 5%、100%。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、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、Hb电泳平行联合检测可提高灵敏度,联合检测可提高特异度。

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 Methods 160 samples of thalassemia patients and 110 samples of non thalassemia controls verified by molecular biologic technique were detected by MCV test、RCOF test and Hb electrophoresis Results The sensitivity and specificity of single test were as follow: Those of MCV were 91 3% and 69 1% respectively, RCOF were 78 1% and 90%, Hb electrophoresis were 71 3% and 91 8% The sensitivity and specificity of parallel combined test of MCV with Hb electrophoresis , RCOF with Hb electrophoresis , MCV 、RCOF with Hb electrophoresis were 97 5%, 93 7%, 100% and 63 6%, 78 2% 61 8% respectively The sensitivity and specificity of serial combined of MCV with Hb electrophoresis, RCOF with Hb electrophoresis, MCV、RCOF with Hb electrophoresis were 71 2%, 68 8%, 67 5% and 97 3%, 99 1%, 100% respectively There were significant differences of sensitivity or specificity between single test and the combination of three or two tests Conclusion Parallel combined test of MCV 、RCOF and Hb electrophoresis increases the sensitivity and serial combined test heightens the specificity in the diagnosis of thalassemia Combined test is superior to each single test itself