MCV、MCH筛查妊娠合并轻型地中海贫血的价值

Value of MCV,MCH Screening Pregnancy with Light Mediterranean Anemia

目的探讨平均红细胞体积（MCV）、平均红细胞血红蛋白含量（MCH）在妊娠合并轻型地中海贫血中筛查价值。方法选取2012-02~2014-03间我院产科门诊行产前检查560例孕妇为研究对象,通过检测患者红细胞计数（RBC）、血红蛋白浓度（Hb）、红细胞分布宽度（RDW）、MCV、MCH,血红蛋白电泳,筛选出贫血患者,采用地贫基因明确诊断地贫患者,根据筛查结果分成正常组（380例）、非地贫组（124例）、地贫组（56例）。对比分析三组红细胞参数,并计算MCV、MCH筛查灵敏度、特异度和诊断符合率。结果非地贫组RBC明显少于正常组和地贫组,差异有统计学意义（P〈0.05）,地贫组和非地贫组Hb明显少于正常组,差异有统计学意义（P〈0.05）,正常组RDW明显少于地贫组和非地贫组,差异有统计学意义（P〈0.05）,地贫组MCV、MCH值明显低于非地贫组和正常组,差异有统计学意义（P〈0.05）。以地贫基因诊断结果为金标准,MCV、MCH筛查灵敏度为91.07%,特异度为90.32%,阳性符合率为91.07%。结论 MCV、MCH筛查妊娠合并轻型地中海贫血具有较高灵敏度、特异度和阳性符合率,检查简便、经济,可作为筛查妊娠合并轻型地中海贫血重要筛查手段。

Objective To explore the value of average red blood cell volume（ MCV）,average red blood cell hemoglobin（ MCH）screening pregnancy with light Mediterranean anemia. Methods Selecting 560 pregnant women from February,2012 to March,2014 in Maternity Department in the hospital in antenatal examination as the research object,through the detection of patients with red blood cell count（ RBC）,hemoglobin（ Hb） concentration,red blood cell distribution width（ RDW）,MCV,MCH,hemoglobin electrophoresis,screening patients with anemia,and using poorest genetic to diagnose poor patients. According to the results of screening,they were divided into normal group（ 380 cases）,not to lean group（ 124 cases） and poor（ 56 cases）. Comparative analysis of three sets of red blood cell parameters was done,and screening sensitivity,specific and diagnostic coincidence rates were calculated. Results RBC not to lean group was obviously less than the normal group and poverty group,and there was statistical significance（ P〈0. 05）,and poor Hb group and not to lean group was obviously less than control group,with statistical significance（ P〈0. 05）,RDW normal group was obviously less than to the poor group and the poor with statistical significance（ P〈0. 05）,and the values of MCV,MCH lean group were obviously lower than lean group and normal group,with statistical significance（ P〈0. 05）. With poor genetic diagnosis results as the gold standard,the MCV,MCH screening sensitivity was 91. 07% and 90. 32%,and positive coincidence rate was 91. 07%. Conclusion MCV,MCH screening pregnancy with light degree of Mediterranean anemia has high sensitivity,specific and positive coincidence rate,the check is simple and economical,and can be used as screening pregnancy with important screening light Mediterranean anemia.