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
|
摘要
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.
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.
引文
[1]王文杰,陈发钦,王琳,等.广西地中海贫血不同基因型血常规参数MCV MCH及血红蛋白电泳检测结果的差异分析[J].中国临床新医学,2017,10(5):426-431.
[2]张雪梅.血细胞与血红蛋白分析在地中海贫血筛查中的应用价值研究[J].当代医学,2017,23(19):13-15.
[3]黄军垣.平均红细胞体积、平均红细胞血红蛋白联合血红蛋白电泳在妊娠女性地中海贫血筛查中的应用价值[J].世界临床医学,2017,11(13):121-122.
[4]林文彬,何小洪,陈培松,等.脐血MCV、MCH和RDW在地中海贫血产前筛查中的应用价值[J].中国卫生检验杂志,2015,25(22):3798-3800.
[5]张翔蓉.血液检验在贫血诊断与鉴别诊断中的价值分析[J].检验医学与临床,2016,13(z2):318-320.
[6]王翠莲.分析血细胞和血红蛋白在地中海贫血中的应用价值[J].中国现代药物应用,2018,12(10):56-58.
[7]温德胜.血细胞和血红蛋白分析技术在地中海贫血筛查中的应用价值[J].河南医学研究,2018,27(10):1811-1812.
[8]李红萍,李培培,张轩,等.CAPILLARYS 2血红蛋白电泳联合MCH筛查地中海贫血应用评价[J].临床血液学杂志,2014,27(6):978-982.
[9]黄英.平均红细胞体积和血红蛋白量在筛查地中海贫血中的价值[J].现代诊断与治疗,2013,24(15):3371-3372.
[10]Li B,Zhang XZ,Yin AH,et al.High prevalence of thalassemia in migrant populations in Guangdong Province,China[J].BMC Public Health,2014,14(1):905.
[11]李莉艳,李强,宋兰林,等.MCV、MCH和血红蛋白A2检测在地中海贫血筛查中的价值[J].中华妇产科杂志,2012,47(2):96-100.
[12]谭诗,李秋红,陈霞,等.地中海贫血筛查的临床应用价值[J].检验医学,2018,33(8):730-733.
[13]郑琳,黄海龙,范向群,等.血细胞和血红蛋白分析在地中海贫血中的应用价值[J].中国妇幼保健,2016,31(3):547-549.
[14]梁栋伟,李荣川,何健,等.MCV、MCH检测在地中海贫血筛查中的应用研究[J].国际检验医学杂志,2014,35(8):960-961.
[15]唐德国,田洁,阳少辉,等.MCV、MCH和HbA2检测在育龄人群地中海贫血筛查中的价值[J].实用预防医学,2017,24(12):1458-1461.
[16]孙秀山,颜洁,管泽琴,等.血常规检测对缺铁性贫血和地中海贫血鉴别诊断中的应用[J].四川医学,2013,34(3):440-441.
[2]张雪梅.血细胞与血红蛋白分析在地中海贫血筛查中的应用价值研究[J].当代医学,2017,23(19):13-15.
[3]黄军垣.平均红细胞体积、平均红细胞血红蛋白联合血红蛋白电泳在妊娠女性地中海贫血筛查中的应用价值[J].世界临床医学,2017,11(13):121-122.
[4]林文彬,何小洪,陈培松,等.脐血MCV、MCH和RDW在地中海贫血产前筛查中的应用价值[J].中国卫生检验杂志,2015,25(22):3798-3800.
[5]张翔蓉.血液检验在贫血诊断与鉴别诊断中的价值分析[J].检验医学与临床,2016,13(z2):318-320.
[6]王翠莲.分析血细胞和血红蛋白在地中海贫血中的应用价值[J].中国现代药物应用,2018,12(10):56-58.
[7]温德胜.血细胞和血红蛋白分析技术在地中海贫血筛查中的应用价值[J].河南医学研究,2018,27(10):1811-1812.
[8]李红萍,李培培,张轩,等.CAPILLARYS 2血红蛋白电泳联合MCH筛查地中海贫血应用评价[J].临床血液学杂志,2014,27(6):978-982.
[9]黄英.平均红细胞体积和血红蛋白量在筛查地中海贫血中的价值[J].现代诊断与治疗,2013,24(15):3371-3372.
[10]Li B,Zhang XZ,Yin AH,et al.High prevalence of thalassemia in migrant populations in Guangdong Province,China[J].BMC Public Health,2014,14(1):905.
[11]李莉艳,李强,宋兰林,等.MCV、MCH和血红蛋白A2检测在地中海贫血筛查中的价值[J].中华妇产科杂志,2012,47(2):96-100.
[12]谭诗,李秋红,陈霞,等.地中海贫血筛查的临床应用价值[J].检验医学,2018,33(8):730-733.
[13]郑琳,黄海龙,范向群,等.血细胞和血红蛋白分析在地中海贫血中的应用价值[J].中国妇幼保健,2016,31(3):547-549.
[14]梁栋伟,李荣川,何健,等.MCV、MCH检测在地中海贫血筛查中的应用研究[J].国际检验医学杂志,2014,35(8):960-961.
[15]唐德国,田洁,阳少辉,等.MCV、MCH和HbA2检测在育龄人群地中海贫血筛查中的价值[J].实用预防医学,2017,24(12):1458-1461.
[16]孙秀山,颜洁,管泽琴,等.血常规检测对缺铁性贫血和地中海贫血鉴别诊断中的应用[J].四川医学,2013,34(3):440-441.