用MCV并联RDW筛查β-地中海贫血的可靠性评价

RELIABILITY ESTIMATION ON THE COMBINED USE OF MCV AND RDW FOR β-THALASSEMIA SCREENING

[目的]研究用红细胞平均容积(MCV)和红细胞分布宽度(RDW)筛查β-地贫的方法和可靠性。[方法]对1966例受检者全血行血细胞分析、血红蛋白(Hb)电泳、β-地贫基因及α-地贫基因检测。统计基因确诊β-地贫患者的MCV、RDW-SD,估计用MCV并联RDW-SD筛查β-地贫的漏检率。[结果]1966例受检者中基因检出498例β地贫,用MCV﹤82fl筛查,漏检7例,漏检率1.4%;用MCV﹤82fl并联RDW-SD﹥50fl筛查,漏检2例,漏检率0.4%,漏检均见于静止型β-地贫。[结论]用MCV并联RDW普查人群筛查β-地贫,包括合并α-地贫者,具有良好的可靠性,漏检仅偶见于静止型地贫。

[Objective] To study the method and the reliability of combined use of MCV and RDW for β-thalassemia screening. [Methods] Hemoglobin electrophoresis, blood cell analysis and detection of α-Globin and β-Globin gene were performed in 1966 patients. Red blood cell indices MCV and RDW-SD were analyzed in β-thalassemia patients whose β-Globin gene mutadon was cordirmed to estimate the missing rate of combined use of MCV and RDW-SD for β-dtalassemia screening. [ Results] Among 1966 patients, 498 patients were diagnosed with β-tbalassenfia by gene detection. Seven cases of β-tha- lassemia were missed for diagnosis when MCV 〈 82fl was applied as screening criterion. The missing rate was 1.4%. When the same MCV er/terion plus RDW-SD 〉 50t1 were used to screen all patients for β-thalassemia, only two eases were missed anti the missing rate was only 0.4%. The missed cases were all silent carriers. [Conclusions] It is relatively reliable for screening of β-thalassemia including concurrent β-thalassemia to use MCV combined with RDW-SD, It has very low missing rate in silent carriers.