用于遗传性球形红细胞增多症筛查和诊断的血细胞参数。
Blood cell parameters for screening and diagnosis of hereditary spherocytosis.
机构信息
Department of Clinical Laboratory, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Department of Pediatric, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
出版信息
J Clin Lab Anal. 2019 May;33(4):e22844. doi: 10.1002/jcla.22844. Epub 2019 Apr 3.
BACKGROUND
There is currently no single index for the diagnostic screening of hereditary spherocytosis (HS). However, hematology analyzers are widely used in hospital laboratories because of their highly automated performance and quality control procedure, and detection of some blood cell parameters may be useful for the early screening of HS.
METHODS
We investigated the values of blood cell parameters for the screening and differential diagnosis of HS. We performed a descriptive study of 482 samples (67 cases of HS, 59 cases of G6PD deficiency, 57 cases of AIHA, 199 cases of thalassemia, and 100 cases of healthy controls) that were run on Beckman Coulter LH780 Hematology Analyzer.
RESULTS
HS was characterized by increased MCHC, decreased MRV, MSCV-MCV < 0, and increased Ret with no concomitant increase in IRF. The areas under the ROC curves were MSCV-MCV (0.97; 95% CI 0.95-1.0) > MRV (0.94; 95% CI 0.91-0.97) > MCHC (0.92; 95% CI 0.88-0.97) > Ret/IRF (0.77; 95% CI 0.7-0.84). MSCV-MCV ≤ 0.6 fl was valuable parameter for the diagnostic screening of HS, with a sensitivity of 95.5% and specificity of 94.9%.
CONCLUSION
These indices have high reference values for differentiating HS from thalassemia, AIHA, and G6PD deficiency.
背景
目前尚无用于遗传性球形红细胞增多症（HS）诊断筛查的单一指标。然而，由于血液分析仪具有高度自动化的性能和质量控制程序，因此在医院实验室中得到了广泛应用，并且一些血细胞参数的检测可能有助于 HS 的早期筛查。
方法
我们研究了血细胞参数在 HS 的筛查和鉴别诊断中的价值。我们对在贝克曼库尔特 LH780 血液分析仪上运行的 482 个样本（67 例 HS、59 例 G6PD 缺乏症、57 例自身免疫性溶血性贫血、199 例地中海贫血和 100 例健康对照）进行了描述性研究。
结果
HS 的特征为 MCHC 升高、MRV 降低、MSCV-MCV<0 和 Ret 增加，但 IRF 没有相应增加。ROC 曲线下面积分别为 MSCV-MCV（0.97；95%CI 0.95-1.0）>MRV（0.94；95%CI 0.91-0.97）>MCHC（0.92；95%CI 0.88-0.97）>Ret/IRF（0.77；95%CI 0.7-0.84）。MSCV-MCV≤0.6 fl 是诊断 HS 的有价值参数，具有 95.5%的灵敏度和 94.9%的特异性。
结论
这些指标对 HS 与地中海贫血、AIHA 和 G6PD 缺乏症的鉴别具有很高的参考价值。
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