国际输血及血液学杂志
國際輸血及血液學雜誌
국제수혈급혈액학잡지
INTERNATIONAL JOURNAL OF BLOOD TRANSFUSION AND HEMATOLOGY
2014年
4期
307-310
,共4页
β-地中海贫血%色谱法,高压液相%血红蛋白电泳%聚合酶链反应-反向斑点杂交法
β-地中海貧血%色譜法,高壓液相%血紅蛋白電泳%聚閤酶鏈反應-反嚮斑點雜交法
β-지중해빈혈%색보법,고압액상%혈홍단백전영%취합매련반응-반향반점잡교법
β-Thalassemia%Hemoglobin electrophoresis%Chromatography,high performance liquid%Polymerase chain reaction and reverse dot blot
目的 探讨高效液相色谱法(HPLC)对于诊断β地中海贫血(β-TM)的临床意义.方法 选择2011年2月至2014年1月,于宜宾市第一人民医院就诊的734例门诊贫血患者为研究对象.采用血常规采血试管采集其血液标本,使用血红蛋白(Hb)电泳、HPLC、聚合酶链反应-反向斑点杂交法(PCR-RDB)对其进行β-TM诊断.本研究遵循的程序符合宜宾市第一人民医院人体试验委员会所制定的伦理学标准,得到该委员会批准,采集血液标本前均经受试对象本人的知情同意,并与之签订临床研究知情同意书.以PCR-RDB为诊断β-TM的金标准,分别与Hb电泳和HPLC诊断该病的灵敏度、特异度和准确度进行统计学分析.结果 本组734例贫血患者经PCR-RDB检测,诊断为β-TM阳性的患者179例,阳性率为24.39％.经Hb电泳检测,诊断为β-TM阳性的患者334例,阳性率为45.50％,检测的灵敏度为98.88％,特异度为71.71％,准确度为78.34％;与PCR-RDB检测法比较,差异有统计学意义(x2=151.10,P＜0.05).经HPLC检测,诊断为β-TM阳性的患者256例,阳性率为34.88％,检测的灵敏度为99.44％,特异度为85.95％,准确度为89.24％;与PCR-RDB检测法比较,差异有统计学意义(x2=75.05,P＜0.05).179例β-TM中,PCR-RDB共检出5种突变基因.结论 在β-TM的筛查中,HPLC的灵敏度、特异度及准确度均高于Hb电泳,筛查效果优于Hb电泳,适合用于β-TM的筛查试验.HPLC联合PCR-RDB对β-TM进行确诊,是目前诊断和干预重型β-TM患儿出生行之有效的方法.
目的 探討高效液相色譜法(HPLC)對于診斷β地中海貧血(β-TM)的臨床意義.方法 選擇2011年2月至2014年1月,于宜賓市第一人民醫院就診的734例門診貧血患者為研究對象.採用血常規採血試管採集其血液標本,使用血紅蛋白(Hb)電泳、HPLC、聚閤酶鏈反應-反嚮斑點雜交法(PCR-RDB)對其進行β-TM診斷.本研究遵循的程序符閤宜賓市第一人民醫院人體試驗委員會所製定的倫理學標準,得到該委員會批準,採集血液標本前均經受試對象本人的知情同意,併與之籤訂臨床研究知情同意書.以PCR-RDB為診斷β-TM的金標準,分彆與Hb電泳和HPLC診斷該病的靈敏度、特異度和準確度進行統計學分析.結果 本組734例貧血患者經PCR-RDB檢測,診斷為β-TM暘性的患者179例,暘性率為24.39％.經Hb電泳檢測,診斷為β-TM暘性的患者334例,暘性率為45.50％,檢測的靈敏度為98.88％,特異度為71.71％,準確度為78.34％;與PCR-RDB檢測法比較,差異有統計學意義(x2=151.10,P＜0.05).經HPLC檢測,診斷為β-TM暘性的患者256例,暘性率為34.88％,檢測的靈敏度為99.44％,特異度為85.95％,準確度為89.24％;與PCR-RDB檢測法比較,差異有統計學意義(x2=75.05,P＜0.05).179例β-TM中,PCR-RDB共檢齣5種突變基因.結論 在β-TM的篩查中,HPLC的靈敏度、特異度及準確度均高于Hb電泳,篩查效果優于Hb電泳,適閤用于β-TM的篩查試驗.HPLC聯閤PCR-RDB對β-TM進行確診,是目前診斷和榦預重型β-TM患兒齣生行之有效的方法.
목적 탐토고효액상색보법(HPLC)대우진단β지중해빈혈(β-TM)적림상의의.방법 선택2011년2월지2014년1월,우의빈시제일인민의원취진적734례문진빈혈환자위연구대상.채용혈상규채혈시관채집기혈액표본,사용혈홍단백(Hb)전영、HPLC、취합매련반응-반향반점잡교법(PCR-RDB)대기진행β-TM진단.본연구준순적정서부합의빈시제일인민의원인체시험위원회소제정적윤리학표준,득도해위원회비준,채집혈액표본전균경수시대상본인적지정동의,병여지첨정림상연구지정동의서.이PCR-RDB위진단β-TM적금표준,분별여Hb전영화HPLC진단해병적령민도、특이도화준학도진행통계학분석.결과 본조734례빈혈환자경PCR-RDB검측,진단위β-TM양성적환자179례,양성솔위24.39％.경Hb전영검측,진단위β-TM양성적환자334례,양성솔위45.50％,검측적령민도위98.88％,특이도위71.71％,준학도위78.34％;여PCR-RDB검측법비교,차이유통계학의의(x2=151.10,P＜0.05).경HPLC검측,진단위β-TM양성적환자256례,양성솔위34.88％,검측적령민도위99.44％,특이도위85.95％,준학도위89.24％;여PCR-RDB검측법비교,차이유통계학의의(x2=75.05,P＜0.05).179례β-TM중,PCR-RDB공검출5충돌변기인.결론 재β-TM적사사중,HPLC적령민도、특이도급준학도균고우Hb전영,사사효과우우Hb전영,괄합용우β-TM적사사시험.HPLC연합PCR-RDB대β-TM진행학진,시목전진단화간예중형β-TM환인출생행지유효적방법.
Objective To investigate the clinical significance of high performance liquid chromatography (HPLC) in diagnosis of β-thalassemia (β-TM).Methods From February 2011 to January 2014,a total of 734 outpatients with anemia in First People's Hospital in Yibin were collected into this study.Blood collection tubes were used to collect their blood samples.Hemoglobin electrophoresis,HPLC and polymerase chain reaction-reverse dot blot (PCR-RDB) were used to diagnose the 734 blood samples whether they were β-TM or not.The study protocol was approved by the Ethical Review Board of Investigation in First People's Hospital in Yibin.Informed consent was obtained from each participate before collecting blood samples.PCR-RDB was used as a gold standard to analyze the sensitivity,specificity and accuracy of hemoglobin electrophoresis and HPLC.Results Among the 734 anemia patients,179 cases were diagnosed as β-TM positive by PCR-RDB and the positive rate was 24.39％.While 334 cases were diagnosed as β-TM positive by hemoglobin electrophoresis and the positive rate was 45.50％.The sensitivity,specificity and accuracy of hemoglobin electrophoresis were 98.88％,71.71％ and 78.34％ respectively (x2 =151.10,P＜0.05).256 cases were diagnosed as β-TM positive by HPLC and the positive rate was 34.88％.The sensitivity,specificity and accuracy of HPLC were 99.44％,85.95％ and 89.24％ respectively (x2 =75.05,P＜0.05).5 kinds of mutations were detected by PCR-RDB among the 179 patients with β-TM.Conclusions In screening β-TM,the sensitivity,specificity and accuracy of HPLC are higher than hemoglobin electrophoresis.The screening effect of HPLC is better than hemoglobin electrophoresis.So HPLC is suitable for screening β-TM.HPLC combined with PCR-RDB is an effective method of diagnosis and intervention in children with severe β-TM.
