CAJ | 학술논문

目的：探讨血液学指标MCV、MCH、MCHC、RDW-SD、HbA2在地中海贫血筛查中的价值。方法：以基因诊断结果为金标准，分析189例地中海贫血患者（α地贫142例，β地贫47例）的血液学检测指标，建立相应的截断值，比较单独与联合应用血液学指标筛查地贫的灵敏度、特异度。结果：地贫患者与健康人MCV、MCH、MCHC、RDW-SD有明显差异（P＜0．01），MCV、MCH、MCHC、RDW-SD 筛查地贫的截断值分别为71．90fL、23．85pg、333．50g／L、37.65fL ，灵敏度分别为91．40％、86．30％、52．40％、78．60％；HbA2在α地贫患者与健康人之间无差异（P＞0．05）， HbA2在β地贫患者与健康人之间有明显差异（P＜0．01），HbA2筛查α地贫的截断值为2．45％，灵敏度为41．50％， HbA2筛查β地贫的截断值为3．25％，灵敏度为91．50％；MCV＋MCH平行联合与MCV单独筛查α、β地贫的灵敏度与特异度均无明显差异（P＞0．05）；HbA2＋MCV平行联合筛查α地贫的灵敏度明显高于 HbA2单独诊断α地贫（P＜0．01），HbA2＋MCV平行联合筛查β地贫特异度明显低于HbA2单独诊断β地贫（P＜0．01）。结论：MCV筛查地贫灵敏度高；HbA2筛查β地贫的灵敏度高；HbA2＋MCV平行联合可以提高筛查α地贫的灵敏度，减少漏检。
목적：탐토혈액학지표MCV、MCH、MCHC、RDW-SD、HbA2재지중해빈혈사사중적개치。방법：이기인진단결과위금표준，분석189례지중해빈혈환자（α지빈142례，β지빈47례）적혈액학검측지표，건립상응적절단치，비교단독여연합응용혈액학지표사사지빈적령민도、특이도。결과：지빈환자여건강인MCV、MCH、MCHC、RDW-SD유명현차이（P＜0．01），MCV、MCH、MCHC、RDW-SD 사사지빈적절단치분별위71．90fL、23．85pg、333．50g／L、37.65fL ，령민도분별위91．40％、86．30％、52．40％、78．60％；HbA2재α지빈환자여건강인지간무차이（P＞0．05）， HbA2재β지빈환자여건강인지간유명현차이（P＜0．01），HbA2사사α지빈적절단치위2．45％，령민도위41．50％， HbA2사사β지빈적절단치위3．25％，령민도위91．50％；MCV＋MCH평행연합여MCV단독사사α、β지빈적령민도여특이도균무명현차이（P＞0．05）；HbA2＋MCV평행연합사사α지빈적령민도명현고우 HbA2단독진단α지빈（P＜0．01），HbA2＋MCV평행연합사사β지빈특이도명현저우HbA2단독진단β지빈（P＜0．01）。결론：MCV사사지빈령민도고；HbA2사사β지빈적령민도고；HbA2＋MCV평행연합가이제고사사α지빈적령민도，감소루검。
Objective :To explore the value of hematology indexes MCV ,MCH ,MCHC ,RDW-SD ,HbA2 in thalassae-mia screening .Methods :The hematology indexes of 189 cases of thalassemia(142 cases of α-thalassemia and 47 cases ofβ-thalassemia) were analyzed by gold standard of gene diagnosis .Set up a corresponding cutoff value .Comparing the sensitivity and specific degrees of single and combined use of hematology indexes screening thalassemia .Results :Thalas-semia and healthy people had significant difference in MCV ,MCH ,MCHC and RDW-SD(P<0 .01) ,the cutoff value of MCV ,MCHC ,MCH and RDW-SD for screening thalassemia were 71 .90fL ,23 .85pg ,333 .50g/L and 37 .65fL ,respec-tively .The sensitivity of MCV ,MCH ,MCHC and RDW-SD for screening thalassemia were 91 .40% ,86 .30% , 52.40% ,78 .60% ,respectively .HbA2 between α-thalassemia and healthy people had no difference (P> 0.05) .HbA2 betweenβ-thalassemia and healthy people had significant difference (P<0 .01) .The screening α-thalassemia cutoff of HbA2 was 2 .45% ,the sensitivity was 41 .50% .The screeningβ-thalassemia cutoff of HbA2 was 3.25% ,the sensitivi-ty was 91 .50% .The sensitivity and specificity of MCV + MCH combined and MCV alone screening α,β-thalassemia were not significantly different (P>0 .05) .The sensitivity of HbA2 +MCV combined screening α-thalassemia was sig-nificantly higher than HbA2 alone (P<0 .01) .The specificity of HbA2 + MCV combined screening β-thalassemia was significantly lower than HbA2 alone (P<0 .01) .Conclusion:MCV screening thalassemia value is higher ,HbA2 screen-ing β-thalassemia value is higher ,HbA2 + MCV parallel combination can improve the sensitivity of screening α-thalas-semia and reduce leak detection .