MCV、MCH在妊娠周期中的变化及其对地贫筛查的价值

Changes of MCV and MCH in pregnancy cycle and their values in screening of thalassemia

目的：探讨平均红细胞体积（MCV）和平均红细胞血红蛋白含量（MCH）在妊娠周期中的变化规律及MCV、MCH对地贫筛查的价值。方法：收集2007年珠海市妇幼保健院正常育龄妇女的血细胞分析数据550例,通过随机数字法取110例,求其平均值为对照组。孕妇血细胞分析数据4 958例为实验组,通过分组求其平均值并通过SPSS 12.0软件画出相应曲线,观察MCV、MCH随孕周不同其值的变化规律,并与对照组进行比较。同时另收集地中海贫血筛查中经基因分析确诊的327例血细胞分析数据,通过受试者工作曲线（ROC）分析MCV、MCH对地贫筛查价值的大小。结果：对照组的MCV平均值为86.7 fl,MCH平均值为29.8 pg。实验组的MCV、MCH随孕周的增长而逐步增大,22~25周左右达高峰,随后下降。MCV的ROC曲线下面积达0.910,MCH的ROC曲线下面积达0.907。对照组与实验组的MCV值在孕26~29周有差异,MCH值在孕22~29周有差异。实验组的MCV、MCH值从孕26周开始下降。结论：孕妇的MCV和MCH随孕周的增加先升后降;MCV和MCH指标在妊娠期均可有效地筛查出地贫携带者。

Objective：To explore the change regularity of mean corpuscular volume（MCV） and mean corpuscular hemoglobin（MCH） in pregnancy cycle and their values in screening of thalassemia.Methods：The data of blood analysis from 550 normal women of childbearing age in the hospital in 2007 were collected,110 cases were selected by random number table as control group,the mean value was calculated;4 958 pregnant women were selected as experimental group,the mean value was calculated.Corresponding curves were drawn according to the mean values in the two groups by SPSS12.0 software;the change regularity of MCV and MCH in different gestational weeks were observed and compared between the two groups;the data of blood analysis from 327 cases with thalassemia diagnosed by gene analysis were collected,the values of MCV and MCH in screening of thalassemia were analyzed by receiver operating characteristics curve（ROC）.Results：The mean values of MCV and MCH were 86.7 fl and 29.8 pg in control group;in experimental group,the mean values of MCV and MCH increased with gestational weeks,peaked on 22-25 gestational weeks,then decreased;the area of MCV under ROC curve was 0.910,the area of MCH under ROC curve was 0.907;there was significant difference in MCV value on 26-29 gestational weeks between control group and experimental group;there was significant difference in MCH value on 22-29 gestational weeks between control group and experimental group;the mean values of MCV and MCH decreased from the 26th gestational week in experimental group.Conclusion：The mean values of MCV and MCH in pregnant women increase first and decrease afterwards with gestational weeks;MCV and MCH may screen out thalassemia carriers effectively during pregnancy.