Xie Yu-Ping, Cao Ying-Ping, Zhu Xian-Jin, Liu Hong-Jin, Liu Jin, Zhou Wen-Juan, Lu Ping-Xia
Department of Clinical Laboratorial Examination, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian Province, China.
Department of Clinical Laboratorial Examination, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian Province, China.E-mail:
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2019 Feb;27(1):165-169. doi: 10.7534/j.issn.1009-2137.2019.01.026.
To analyze the genotypes and the hematological phenotypic characteristics of α-thalassemia in different areas of Fujian and to evaluate the values of mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), hemoglobin (Hb), RBC distribution width/red blood cell (RDW/RBC) for screening α-thalassemia in this area.
The Gap-PCR assay was applied for detecting 3 common deletional mutations of patients with α-thalassemia, and the reverse dot-blot (RDB) assay was adopted to detect the foci of 3 common non-deletional gene mutations.Then,the hematological parameters of individuals with α-thalassemia were analyzed. Finally, the optimal cut-off value in hematological indexes for screening α-thalassemia were determined by the ROC curve.
Altogether 16 types of gene mutations were found in 772 patients with α-thalassemia. Among them, the -SEA/αα deletion mutation was the most common which was observed in 521 cases(67.49%). Compared with the control group, the differences in MCV, MCH, and Hb were statistically significant between the patients of the same sex but no same type. In male groups, the RDW/RBC ratio was statistically significant in individuals of light type and HbH disease as compared with the healthy control group. But in female groups, the statistical different of RDW/RBC ratio was found between only HbH disease group and control group. MCV<81.25 fl, MCH<27.30 pg, Hb(male)<128.5 g/L, and Hb(female) <123.5 g/L, with the highest specificity and the highest sensitivity, were the best cut-off points for screening α-thalassemia in the laboratory.
Due to the difference of regional heterogeneity and hospital equipment environment, the different laboratories need to establish cut-off value for screening α-thalassemia suitable for its local region. In future, our laboratory can use MCV<81.25 fl, MCH<27.30 pg, Hb(male)<128.5 g/L, and Hb(female) <123.5 g/L for value for clinical screening, of α-thalassemia.
分析福建不同地区α地中海贫血的基因型及血液学表型特征,评估平均红细胞体积(MCV)、平均红细胞血红蛋白含量(MCH)、血红蛋白(Hb)、红细胞分布宽度/红细胞(RDW/RBC)在该地区筛查α地中海贫血的价值。
采用Gap-PCR法检测α地中海贫血患者3种常见缺失型突变,采用反向点杂交(RDB)法检测3种常见非缺失型基因突变位点。然后,分析α地中海贫血患者的血液学参数。最后,通过ROC曲线确定筛查α地中海贫血的血液学指标最佳截断值。
772例α地中海贫血患者共检测出16种基因突变类型。其中,-SEA/αα缺失型突变最为常见,共521例(67.49%)。与对照组相比,相同性别但不同类型患者的MCV、MCH和Hb差异有统计学意义。男性组中,轻型和血红蛋白H病患者的RDW/RBC比值与健康对照组相比差异有统计学意义。而女性组中,仅血红蛋白H病组与对照组的RDW/RBC比值差异有统计学意义。MCV<81.25 fl、MCH<27.30 pg、Hb(男性)<128.5 g/L、Hb(女性)<123.5 g/L,具有最高特异性和最高敏感性,是实验室筛查α地中海贫血的最佳截断点。
由于地区异质性和医院设备环境的差异,不同实验室需要建立适合本地区的α地中海贫血筛查截断值。未来,本实验室可采用MCV<81.25 fl、MCH<27.30 pg、Hb(男性)<128.5 g/L、Hb(女性)<123.5 g/L作为临床筛查α地中海贫血的指标。