新生儿血常规指标在珠蛋白生成障碍性贫血筛查中的应用价值研究

Application value of neonatal blood routine indexes in screening of thalassemia

目的探讨新生儿血红蛋白（Hb）、平均红细胞体积（MCV）、平均红细胞血红蛋白（MCH）及红细胞平均分布宽度变异系数（RDW-CV）等血常规指标在珠蛋白生成障碍性贫血（后简称地贫）筛查中的临床应用价值。方法选取2015年3~12月,在该院经基因确诊携带有地贫基因的150例新生儿（出生28d以内）作为地贫组,同期经确诊排除地贫基因携带的新生儿150例作为健康对照组。对2组新生儿的血常规相关指标Hb、MCV、MCH、RDW-CV进行比较,同时比较α-地贫及β-地贫血常规指标的差异。结果携带有地贫基因的新生儿Hb、MCV、MCH等检测指标的结果低于健康对照组,但RDW-CV高于健康对照组,差异有统计学意义（P〈0.05）。各类型地贫基因携带者中,β-地贫组的Hb、MCV、MCH均低于α-地贫组,差异有统计学意义（P〈0.05）,但两者的RDW-CV差异无统计学意义（P〉0.05）。结论地贫各基因型Hb、MCV和MCH呈下降趋势,但RDW-CV增加。新生儿血常规指标（Hb、MCV、MCH、RDW-CV）在地贫的筛查中具有重要意义,可用于大规模人群地贫筛查。

Objective To investigate the clinical value of the blood routine indexes,including hemoglobin（Hb）,mean erythrocyte volume（MCV）,mean erythrocyte hemoglobin（MCH）and coefficient of variation of the red cell distribution width（RDW-CV）in screening of neonatal thalassemia.Methods A total of 150newborns（born 28 days or less）who were diagnosed as thalassemia gene carriers were selected as the thalassemia group from March 2015 to December 2015 in the hospital.In the same period,the other 150 healthy newborns were selected as control group.Hb,MCV,MCH and RDW-CV were compared between the two groups and the differences of the blood indexes between thalassemia group and thalassemia group were compared.Results The levels of Hb,MCV and MCH in the newborns carried gene of the thalassemia were lower than those of the control group,but RDW-CV was higher than that of the control group,and the differences were statistically significant（P〈0.05）.The levels of Hb,MCV and MCH ofβ-thalassemia newborns were lower than that of theα-thalassemia newborns,the differences was statistically significant（P〈0.05）,but there was no significant difference in RDW-CV between the two groups（P〉0.05）.Conclusion The levels of Hb,MCV and MCH of the newborns with thalassemia of different genotypes shows a decreasing trend,but the RDW-CV has increased.The blood routine indexes of the newborns play an important role in the screening for thalassemia,which can be used for large-scale screening of thalassemia.