孕妇七项血液指标诊断东南亚型α-地中海贫血的价值
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摘要
目的评价测定血红蛋白A2(Hb A2)、红细胞计数(RBC)、血红蛋白(Hb)、平均红细胞体积(MCV)、红细胞分布宽度变异系数(RDW-CV)、红细胞计数与血红蛋白比值(RBC/Hb)、红细胞计数平均红细胞体积比值(RBC/MCV)七项指标诊断东南亚型α-地中海贫血孕妇的价值。方法回顾性分析2010年6月23日至2014年11月10日期间于广州市番禺区中心医院进行α-地中海贫血基因检测且年龄段在18至30岁的女性资料共172例,所有受检者根据检测结果分为健康孕妇组(n=47)、--SEA/αα孕妇组(n=55)、--SEA/αα非孕妇组(n=34)及其他贫血孕妇组(n=36)四组,各组均数间的比较采用独立样本的t检验,并采用ROC曲线对七项指标的准确性进行评价。结果 (1)--SEA/αα孕妇组与健康孕妇组的七项指标比较差异均有统计学意义(P<0.05);(2)MCV、RBC/Hb两项指标在--SEA/αα孕妇组与--SEA/αα非孕妇组间比较差异均具有统计学意义(P<0.05);(3)--SEA/αα孕妇组RBC、Hb、MCV、RBC/Hb、RBC/MCV五项指标与其他贫血孕妇组比较差异均具有统计学意义(P<0.05);(4)Hb A2、RBC、MCV、Hb、RDW-CV、RBC/Hb、RBC/MCV七项指标的曲线下面积(AUC)分别为0.795、0.880、1.000、0.910、0.925、1.000、0.991;灵敏度分别为0.579、0.855、1.000、0.872、0.982、1.000、0.945;特异度分别为0.852、0.745、1.000、0.800、0.892、1.000、0.957;阳性预测值分别为0.741、0.796、1.000、0.880、0.915、1.000、0.981;阴性预测值分别为0.733、0.813、1.000、0.788、0.916、0.959、0.938。结论根据不同群体选择不同血液指标可有效筛查出妊娠合并--SEA/αα患者,但Hb A2在孕妇这个群体中的诊断价值不高,不能进行有效诊断,应避免单独检测。
Objective To evaluate the clinical value of hemoglbbin A2(Hb A2), red blood cell(RBC), hemoglbbin(Hb), mean corpuscular volume(MCV), red blood cell distribution width-coefficient of variation(RDW-CV),ratio of RBC to Hb, ratio of RBC to MCV in the screening of Southeast Asian type α-thalassemia during pregnancy.Methods The clinical data of 172 women(aged 18~30 years old) who received α-thalassemia gene detection in our hospital from June 23, 2010 to November 10, 2014 were retrospectively analyzed. According to test results, the subjects were divided into four groups: 47 cases of healthy pregnant women(healthy pregnant group), 55 cases of--SEA/ααpregnant women(--SEA/αα pregnant group), 34 cases of--SEA/αα non-pregnant women(--SEA/αα non-pregnant group),and 36 cases of pregnant women with other types of anemia(anemia pregnant group). Each group were detected and analyzed by independent-samples t-test. ROC curves were used to evaluate the accuracy of the seven indicators.Results(1)--SEA/αα pregnant group and healthy pregnant group showed no statistically significant difference in the seven indicators(P<0.05).(2)--SEA/αα pregnant group and--SEA/αα non-pregnant group showed statistically significant difference in MCV, RBC/Hb(P<0.05).(3)--SEA/αα pregnant group and anemia pregnant group had statistically significant difference in RBC, Hb, MCV, RBC/Hb, RBC/MCV(P<0.05).(4) The area under the curve(AUC) of Hb A2, RBC, MCV,Hb, RDW-CV, RBC/Hb, RBC/MCV were 0.795, 0.880, 1.000, 0.910, 0.925, 1.000, 0.991. The sensitivity was 0.579,0.855, 1.000, 0.872, 0.982, 1.000, 0.945, and the specificity was 0.852, 0.745, 1.000, 0.800, 0.892, 1.000, 0.957, respectively. The positive predictive values were 0.741, 0.796, 1.000, 0.880, 0.915, 1.000, 0.981, and the negative predictive values were 0.733, 0.813, 1.000, 0.788, 0.916, 0.959, 0.938. Conclusion Choosing different blood parameters based on different groups can effectively screen out patients of pregnancy with--SEA/αα. The diagnostic value of Hb A2 in this group of pregnant women is not high, which can not diagnose effectively and should be avoided to be detected alone.
Objective To evaluate the clinical value of hemoglbbin A2(Hb A2), red blood cell(RBC), hemoglbbin(Hb), mean corpuscular volume(MCV), red blood cell distribution width-coefficient of variation(RDW-CV),ratio of RBC to Hb, ratio of RBC to MCV in the screening of Southeast Asian type α-thalassemia during pregnancy.Methods The clinical data of 172 women(aged 18~30 years old) who received α-thalassemia gene detection in our hospital from June 23, 2010 to November 10, 2014 were retrospectively analyzed. According to test results, the subjects were divided into four groups: 47 cases of healthy pregnant women(healthy pregnant group), 55 cases of--SEA/ααpregnant women(--SEA/αα pregnant group), 34 cases of--SEA/αα non-pregnant women(--SEA/αα non-pregnant group),and 36 cases of pregnant women with other types of anemia(anemia pregnant group). Each group were detected and analyzed by independent-samples t-test. ROC curves were used to evaluate the accuracy of the seven indicators.Results(1)--SEA/αα pregnant group and healthy pregnant group showed no statistically significant difference in the seven indicators(P<0.05).(2)--SEA/αα pregnant group and--SEA/αα non-pregnant group showed statistically significant difference in MCV, RBC/Hb(P<0.05).(3)--SEA/αα pregnant group and anemia pregnant group had statistically significant difference in RBC, Hb, MCV, RBC/Hb, RBC/MCV(P<0.05).(4) The area under the curve(AUC) of Hb A2, RBC, MCV,Hb, RDW-CV, RBC/Hb, RBC/MCV were 0.795, 0.880, 1.000, 0.910, 0.925, 1.000, 0.991. The sensitivity was 0.579,0.855, 1.000, 0.872, 0.982, 1.000, 0.945, and the specificity was 0.852, 0.745, 1.000, 0.800, 0.892, 1.000, 0.957, respectively. The positive predictive values were 0.741, 0.796, 1.000, 0.880, 0.915, 1.000, 0.981, and the negative predictive values were 0.733, 0.813, 1.000, 0.788, 0.916, 0.959, 0.938. Conclusion Choosing different blood parameters based on different groups can effectively screen out patients of pregnancy with--SEA/αα. The diagnostic value of Hb A2 in this group of pregnant women is not high, which can not diagnose effectively and should be avoided to be detected alone.
引文
[1]喻晶,张恋.孕妇珠蛋白生成障碍性贫血的临床血液学筛查指标分析[J].现代检验医学杂志,2013,28(1):138-140.
[2]毛锦江.血细胞分析对妊娠合并地中海贫血筛查的价值[J].中国妇幼健康研究,2010,21(4):498-500.
[3]黄瑛,郭柳薇.东南亚缺失型地中海贫血的临床血液学分析[J].实用性妇产科杂志,2009,25(8):504-505.
[4]董孝平,魏炳华.血细胞分析对妊娠合并地中海贫血筛查的价值[J].临床和实验医学杂志,2011,10(8):617-618.
[5]蒋晴.妊娠合并轻型地中海贫血的筛查及妊娠结局分析[J].健康之路,2014,13(3):85.
[6]喻晶,郑金龙.采用ROC曲线分析东南亚缺失型珠蛋白合成障碍性贫血的血液学指标[J].现代检验医学杂志,2011,26(5):58-61.
[7]方红辉,谭曙明.101例α-地中海贫血基因携带者血常规参数测定及分析[J].山东医药,2009,49(23):102-103.
[8]汪国庆,周玉球.妊娠期MCV和MCH指标筛查珠蛋白生成障碍性贫血的价值[J].国际检验医学杂志,2011,32(8):859-863.
[2]毛锦江.血细胞分析对妊娠合并地中海贫血筛查的价值[J].中国妇幼健康研究,2010,21(4):498-500.
[3]黄瑛,郭柳薇.东南亚缺失型地中海贫血的临床血液学分析[J].实用性妇产科杂志,2009,25(8):504-505.
[4]董孝平,魏炳华.血细胞分析对妊娠合并地中海贫血筛查的价值[J].临床和实验医学杂志,2011,10(8):617-618.
[5]蒋晴.妊娠合并轻型地中海贫血的筛查及妊娠结局分析[J].健康之路,2014,13(3):85.
[6]喻晶,郑金龙.采用ROC曲线分析东南亚缺失型珠蛋白合成障碍性贫血的血液学指标[J].现代检验医学杂志,2011,26(5):58-61.
[7]方红辉,谭曙明.101例α-地中海贫血基因携带者血常规参数测定及分析[J].山东医药,2009,49(23):102-103.
[8]汪国庆,周玉球.妊娠期MCV和MCH指标筛查珠蛋白生成障碍性贫血的价值[J].国际检验医学杂志,2011,32(8):859-863.