血常规红细胞参数对β地中海贫血诊断、筛查价值探讨

A Study into Erythrocyte Indices in β-thalassemia Patient

目的对轻型、重型两类β地中海贫血患者的血常规红细胞参数进行分析,以进一步揭示和探讨红细胞参数在β地贫筛查和诊断中的临床意义。方法分别分析38例轻型β地中海贫血、35例重型β地中海贫血患者红细胞参数的变化趋势和分布特点,并通过ROC曲线讨论各参数对两类β地贫患者的诊断、筛查价值及最佳临界值。结果在筛查轻型β地中海贫血时,MCV、MCH、RBC三指标的ROC曲线下面积分别为0.985、0.983、0.976,其最佳筛查临界值分别为74.25fl、23.8pg、4.215×1012/L;在诊断重型β地贫时,MCV、MCH、RBC、RDW四指标的ROC曲线下面积分别为0.905、0.714、0.916、0.940,其最佳筛查临界值分别为81fl、26.65、3.465×1012/L、20.55%。结论红细胞参数对轻型β地贫的筛查价值最为突出,但其独特的血液学特征对重型β地贫患者也具有一定的辅助诊断价值;血常规中红细胞参数以MCV最为有筛查、诊断价值,RBC、RDW、MCH也有部分参考价值。

Objective Study of the erythrocyte indices in β thalassemia trait and β thalassemia major and discuss the clinic application of the erythrocyte indices in thalassemia screening and diagnosis. Methods Analysis the tendency and distribution of the erythrocyte indices in β thalassemia, moreover,discussion the value and cutoff value of erythrocyte indices in thalassemia screening and diagnosis by ROC curve,Result In β thalassemia trait screening,the area under the ROC curve of MCV, MCII, RBC is;0. 985, 0.983, 0,976,the cutoff value is：74.25f1, 23.8pg, 4.215 × 10^12/L,in β tbalassemia major diagnosis,the area under the ROC curve of MCV, MCII, RBC, RDW is 0.905, 0.714, 0.916, 0.940,the cutoff value is：81f1, 26.65, 3. 465 × 10^12/L, 20.55%.Conclusion there is great value to β thalassemia individuals with erythrocyte indices,especially to thalassemia trait.The MCV can be use as a important parameter in initial screening,the RBC, MCH and the RDW also should be paid attention to.