血清转铁蛋白受体及血常规对地中海贫血患儿的诊断价值

Diagnostic value of serum transferrin receptor and blood routine in children with thalassemia

目的探讨血清转铁蛋白受体及血常规指标对地中海贫血患儿的诊断价值。方法回顾性选取2019年10月至2021年10月大连大学附属新华医院收治的地中海贫血患儿106例设为贫血组,选取同期体检中心50名无贫血症状或造血功能异常的儿童作为对照组。检测并比较两组研究对象的血清转铁蛋白受体(TfR)、红细胞分布宽度与红细胞计数比值(RDW/RBC)、红细胞平均血红蛋白量(MCH)以及血红蛋白A_(2)(HbA_(2))水平;并探究上述指标对地中海贫血患儿的检测价值。结果贫血组患儿的TfR、RDW/RBC、HbA_(2)水平高于对照组,MCH水平低于对照组,差异有统计学意义(P<0.05)。ROC曲线显示,TfR、RDW/RBC、MCH、HbA_(2)应用于评估地中海贫血的AUC分别为0.942、0.955、0.967及0.781;灵敏度分别为86.8%、85.8%、90.6%、62.3%;特异度分别为92.0%、93.0%、93.0%、80.00%;其中TfR、RDW/RBC以及MCH对地中海贫血的灵敏度均处于80%以上,特异度均处于90%以上。结论TfR、RDW/RBC、MCH、HbA_(2)应用于地中海贫血患者的诊断以及筛查均具有一定的参考价值,值得借鉴应用。

Objective To explore the diagnostic value of serum transferrin receptor and blood routine index in children with thalassemia.Methods A total of 106 children with thalassemia admitted to Xinhua Hospital Affiliated to Dalian University from October 2019 to October 2021 were retrospectively selected as the anemia group,and 50 children with no symptoms of anemia or abnormal hematopoietic function were selected as the control group.Serum transferrin receptor(TfR),erythrocyte distribution width to erythrocyte count ratio(RDW/RBC),mean erythrocyte hemoglobin volume(MCH)and hemoglobin A_(2)(HbA_(2))levels were detected and compared between the two groups.And to explore the value of the above indicators in the detection of thalassemia children.Results The levels of TfR,RDW/RBC and HbA_(2) in the anemia group were higher than those in the control group,while the levels of MCH were lower than those in the control group,the differences were statistically significant(P<0.05).ROC curve showed that the AUCs of TfR,RDW/RBC,MCH and HbA_(2) for thalassemia were 0.942,0.955,0.967 and 0.781,respectively.The sensitivity were 86.8%,85.8%,90.6%and 62.3%,respectively.The specificity was 92.0%,93.0%,93.0%and 80.00%,respectively.The sensitivity of TfR,RDW/RBC and MCH to thalassemia was above 80%,and the specificity was above 90%.Conclusion TfR,RDW/RBC,MCH and HbA_(2) have certain reference value in the diagnosis and screening of thalassemia.