观察产前筛查地中海贫血中MCV和RBC脆性及血红蛋白电泳的应用

Application of Mediterranean MCV and RBC Brittleness and Hemoglobin Electrophoresis in Prenatal Screening of Thalassemia

目的:观察临床采用MCV(平均红细胞体积,mean corpuscular volume)和RBC(红细胞,Erythrocytes)脆性及Hb(血红蛋白,hemoglobin)电泳进行产前筛查地中海贫血的临床价值。方法:选取2016年1月~2017年3月期间于某院行产前检查通过基因诊断后确诊的300例地中海贫血孕妇设为试验组,另选取同期于某院行产前检查的非地贫孕妇300例设为对照组,均测定两组MCV,行RBC与Hb电泳试验,对单项及3项试验结果进行对比分析,并对3项试验检测地中海贫血的特异度、灵敏度等进行评价。结果:地贫筛选过程中MCV特异性相对于RBC脆性、Hb电泳较低,但Hb电泳、RBC脆性的灵敏度相抵偏低;各试验平行联合检测的灵敏度、阴性预测值均相对得到了提高,但降低了特异度、阳性预测值;系列联合检测则对于特异度、阳性预测值有提高效果,但是降低了灵敏度、阴性预测值;平行检测与单项检测比较其灵敏度、阴性预测值得到明显提高(P<0.05),系列检测与单项检测比较其特异度、阳性预测值得到明显提高(P<0.05)。结论:MCV、RBC脆性及Hb电泳3项联合检测筛查地贫效果较佳,优于单项检测,值得临床推广应用。

Objective:To observe the clinical value of Mediterranean MCV and RBC brittleness and hemoglobin electrophoresis in prenatal screening of thalassemia.Methods:300 cases of thalassemia patients diagnosed in a hospital from January 2016 to March 2017 were established as the experimental group,and another300 cases of pregnant women without thalassemia in a hospital during the same period were selected as control group.The MCV of Both two groups were measured,and the RBC and Hb electrophoresis test were performed in the two groups.A comparative analysis of the results of single and three trials was carried out and the specificity and sensitivity of the three tests for the detection of thalassemia were evaluated.Results:Compared with RBC brittleness and Hb electrophoresis,the MCV specificity in screening of thalassemia was relatively lower.However,the sensitivity of Hb electrophoresis and RBC brittleness was relatively lower.The sensitivity and negative predictive value of parallel combined test were improved,but the specificity and positive predictive value were decreased.Compared with the single item detection,the sensitivity and the negative predictive value of parallel testing was significantly improved(P<0.05).Compared with the single test,the specificity and the positive predictive value of series of test was significantly improved(P<0.05).Conclusion:The combined detection of MCV and RBC brittleness and HB electrophoresis is more effective than single detection in screening of thalassemia,which is worthy of promotion and application in clinic.