妊娠期MCV和MCH指标筛查珠蛋白生成障碍性贫血的价值

A comparative study of MCV and MCH in the screening of thalassemia during pregnancy

目的 比较妊娠期平均红细胞体积（MCV）和平均红细胞血红蛋白含量（MCH）筛查珠蛋白生成障碍性贫血的价值.方法 收集2007年1-7月珠海市妇幼保健院2 669例孕妇首次产检的红细胞指标、血红蛋白分析和珠蛋白生成障碍性贫血基因分析结果资料（静止型α珠蛋白生成障碍性贫血除外）.以基因诊断结合血液学表型分析结果作为评判标准,分别计算MCV、MCH对珠蛋白生成障碍性贫血诊断的灵敏度和特异度,并通过受试者工作曲线（ROC）评价MCV、MCH对珠蛋白生成障碍性贫血的筛查价值.结果 MCV和MCH筛查妊娠期珠蛋白生成障碍性贫血的灵敏度均为99.2%,特异度分别为64.1%和62.6%,两者的ROC曲线差异无统计学意义.结论 MCV、MCH均可有效地筛出妊娠期珠蛋白生成障碍性贫血.基于MCH值的稳定性,推荐该指标作为妊娠期筛查珠蛋白生成障碍性贫血的一线指标.

Objective To evaluate the clinical value of mean corpuscular volume （MCV）and mean corpuscular homoglobin （MCH） in the screening of thalassemia during pregnancy. Methods Analytical results of red cell indexes,hemoglobin analysis and gene diagnosis were collected from 2 669 pregnant women at the first time of prenatal care in Zhuhai municipal maternity and child healthcare hospital. The sensitivity and specificity of MCV and MCH for the diagnosis of thalassemia were analyzed,taking the re- suits of genetic diagnosis and hematology analysis as criterion. The clinical value of MCV and MCH for the screening of thalassemia was evaluated by receiver operating characteristic（ROC）curve. Results The sensitivity of MCV and MCH in the screening of thalassemia were both 99.2%,and the specificity of each were 64.1% and 62.6 %, respectively. There was no significant difference of ROC curve between MCV and MCH. Conclusion Both MCV and MCH could be used for the screening of thalassemia in preg nant women. MCH might be recommended,based on its fine stability.