脐血MCV、MCH和RDW在地中海贫血产前筛查中的应用价值

Clinical value of MCV,MCH and RDW of fetal blood in prenatal screening of thalassemia

目的探讨脐血血常规参数MCV、MCH及RDW在胎儿地中海贫血产前筛查中的应用价值。方法收集胎儿脐血309例,分别进行血常规和地中海贫血基因检测。以地中海贫血基因检测结果为标准,评价MCV、MCH及RDW在胎儿地中海贫血产前筛查中的应用价值。结果 309例脐血样本中,正常样本133例,地中海贫血样本176例,其中α地中海贫血113例,β地中海贫血58例,α、β复合地中海贫血5例。胎儿α地中海贫血组及α、β复合地中海贫血组的脐血MCV和MCH明显低于正常组,α地中海贫血组RDW明显高于正常组,差异均有统计学意义(P<0.05),β地中海贫血组的MCV、MCH和RDW与正常组相比差异均无统计学意义(P>0.05)。MCV、MCH和RDW的ROC曲线下面积分别为0.754、0.805和0.646,筛查胎儿地中海贫血的MCV、MCH和RDW cut-off值分别为103.75 fl、35.54 pg和15.5%。结论脐血血常规参数MCV、MCH及RDW可用于筛查α地中海贫血和α、β复合地中海贫血。

Objective To investigate the clinical value of MCV, MCH and RDW of fetal blood in prenatal screening of thalasse- mia. Methods 309 fetal bloods were collected to conduct routine blood detection and thalassemia gene detection. The clinical value of MCV, MCH and RDW in prenatal screening of thalassemia before producing was evaluated, regarding the test results of thalassemia gene as standards. Results Among 309 fetal bloods, 133 were normal genotypes and 176 were thalassemia （113 were α- thalassemia, 58 were β- thalassemia and 5 were α, β- thalassemia）. The results of MCV, MCH in α- thalassemia group and αβ - thalassemia group were much lower than that in the normal group, while RDW in α - thalassemia group was higher than that in the normal group, and the differences had statistical significance （P 〈 0.05）. And there was no statistical significance on the differences on MCV, MCH and RDW between β - thalassemia group and normal group （ P 〉 0.05 ）. The ar- eas under the ROC curve of MCV, MCH and RDW were 0. 754, 0. 805 and 0. 646, respectively. And the cut - off values of MCV, MCH and RDW to screen fetal thalassemia were 103.75 fl, 35.54 pg and 15.5%, respectively. Conclusion The data of MCV, MCH and RDW in fetal blood routine test can be used to screen ot - thalassemia and α,β - thalassemia.