血细胞分析对妊娠合并地中海贫血筛查的价值

Values of blood cells analysis for screening of pregnancy associated with thalassemia

目的 探讨测定红细胞平均体积、平均红细胞血红蛋白含量和红细胞计数在妊娠合并轻型α-地中海贫血筛查中的价值及异常妊娠史的发生率.方法 回顾性分析2006年至2009年间在广西医科大学第八附属医院经系统产前检查并住院分娩的孕妇资料共450例,将其分为3组：经基因诊断确诊为轻型α-地中海贫血孕妇150例为地贫组;经血清铁测定确诊为缺铁性贫血的孕妇150例为缺铁性贫血组;正常孕妇150例为对照组.对所有病例分别进行红细胞平均体积和平均红细胞血红蛋白含量及红细胞计数测定,并加以分析.结果 地贫组红细胞平均体积及平均红细胞血红蛋白含量明显低于缺铁性贫血组（t分别为3.499、7.639,均P〈0.01）和对照组（t分别为37.395、70.677,均P〈0.01）,而红细胞计数则明显高于缺铁性贫血组（t=31.429,P〈0.01）和对照组（t=16.666,P〈0.01）.地贫组和缺铁性贫血组的异常妊娠史发生率明显高于对照组（u分别为667.567、500.000,均P〈0.01）.结论 检测红细胞平均体积、平均红细胞血红蛋白含量、红细胞计数可作为筛查轻型α-地中海贫血的指标,轻型α-地中海贫血患者能够妊娠至足月并分娩.

Objective To explore values of mean corpuscular volume （MCV）, mean corpuscular hemoglobin （MCH） and red blood cell count（RBC） for screening of mild α-thalassemia in pregnant women and incidence rate of abnormal pregnanancy. Methods The clinical data of 450 pregnant women who received systematic antenatal examination and delivered in The Eighth Affiliated Hospital of Guangxi Medical University in a period from 2006 to 2009 were retrospectively analyzed. According to the examination results, the pregnant women were divided into three groups： 150 pregnant women who were diagnozed as pregnancy asociated with mild α-thalassaemia by molecular biologic technique （genetic diagnostic technique） were divided into thalassaemia group, 150 pregnant women who were diagnosed as iron deficient anemia by serological iron detection were divided into iron deficient anemia group and 150 normal pregnant women were divided into control group. All pregnant women were examined for MCV, MCH and RBC and their abnormal pregnancy histories were compared. Results MCV and MCH of pregnant women in thalassaemia group were significantly lower than those in both iron deficient anemia group （ MCV： t = 3. 499, MCH ： t = 7.639, both P 〈 0. 01 ） and in the control group （ MCV ： t = 37. 395, MCH： t = 70.677, both P 〈 0.01 ）, while RBC was higher than that in both iron deficient anemia group（ t = 31. 429, P 〈 0.01 ） and that in the control group（t = 16. 666, P 〈 0. 01 ）. The incidence rate of abnormal pregnanant history in either thalassaemia group （ u = 667. 567 ） or iron deficient anemia group （ u = 500.000） was both higher than that in the control group（both P 〈0.01 ）. Conclusion Laboratory examination of MCV, MCH and RBC may be an index in screening of thalassaemia. Those women with mild α-thalassemia can conceive and maintain their pregnancy till to the full term and successfully deliver a healthy baby.