血常规平均红细胞体积、平均血红蛋白量在产前地中海贫血筛查中的应用价值分析

Application value analysis of mean corpuscular volume and mean corpuscular hemoglobin in the prenatal screening of thalassemia

目的分析应用平均红细胞体积(MCV)、平均血红蛋白量(MCH)、对地中海贫血进行产前筛查的价值。方法取2017年6月～2018年3月产前孕检为地贫的90例孕妇为观察组,挑选同期孕检结果血常规结果无异常的97例孕妇为正常组,组间比较受检者MCV、MCH水平差异,对比应用单独指标以及联合两项指标,用于产前地贫筛选的价值(阴性预测值、敏感度、阳性预测值、特异度、诊断率)。结果多组间比较准确率、灵敏度、阴性预测值、阳性预测值差异无统计学意义(P> 0.05),特异度差异有统计学意义(P <0.05),组间两两比较MCH+MCV准确率、特异度、阳性预测值均高于MCV,MCH+MCV检查特异度高于MCH,差异有统计学意义(P <0.05);不同类型地贫者MCV、MCH值两两比较,差异无统计学意义(P> 0.05),且均低于正常组,差异有统计学意义(P <0.05)。结论 MCV、MCH是产前地贫筛查灵敏度较高的指标,用于产前地贫检测诊断准确度良好,特异度较差,但两种联合检查在一定程度上能提高特异度。

Objective To analyze the value of mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) in the prenatal screening of thalassemia. Methods From June 2017 to March 2018,90 pregnant women with thalassemia were selected as the observation group.97 pregnant women without abnormal blood routine results were selected as the normal group.The difference of MCV and MCH levels between the two groups was compared.The value of single and combined indicators for prenatal screening of thalassemia were compared (negative predictive value,sensitivity,positive predictive value,specificity,diagnostic rate). Results There was no significant difference in accuracy,sensitivity,negative predictive value and positive predictive value among the groups (P>0.05),and there was significant difference in specificity of the groups (P<0.05).The accuracy,specificity and positive predictive value of MCH+MCV were higher than those of MCV,and the specificity of MCH+MCV was higher than that of MCH,P<0.05.There was no difference in MCV and MCH between different types of thalassaemia,P>0.05,and both were lower than the normal group,P<0.05. Conclusion MCV and MCH are sensitive indicators of prenatal screening of thalassemia.They have good diagnostic accuracy but poor specificity for prenatal thalassemia detection, however,the combined examination of MCV and MCH can improve the specificity to a certain extent.