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[红细胞、网织红细胞血红蛋白及血红蛋白A2联合检测在地中海贫血中的临床价值]

[The Clinical Value of Combined Detection of RBC, Ret-He and HbA2 for Thalassemia].

作者信息

Yuan Qiu-Rong, Niu Shi-Qiong, Lin Xue-Ping, Luo Zhao-Fan

机构信息

Department of Clinical Laboratory Examination,The Seventh Affiliated Hospital of Sun Yat-sen University,Shenzhen 518000,Guanghdong Province, China.

Department of Clinical Laboratory Examination,The Seventh Affiliated Hospital of Sun Yat-sen University,Shenzhen 518000,Guanghdong Province, China,E-mail:

出版信息

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2021 Feb;29(1):203-206. doi: 10.19746/j.cnki.issn.1009-2137.2021.01.032.

Abstract

OBJECTIVE

To investigate the distribution of Ret-He and RBC in thalassemia and the value of combining HbA2 in the detection of thalassemia among patients with microcytic or hypochromic.

METHODS

145 patients with microcytic or hypochromic outpatient or hospitalization in our hospital from May 2018 to December 2019 were selected and were divided into the thalassemia group(68 cases) and the non-thalassemia group (77 cases), and at the same time, the patients were divided into four groups of the non-anemia, mild anemia, moderate anemia and severe anemia group according to the degree of anemia. The Ret-He, RBC, RDW-CV and HbA2 in patients were detected, and the distribution of these parameters were compared, and the joint detection of Ret-He, RBC and HbA2 about its sensitivity, specific and other indicators of auxiliary diagnosis of thalassemia were analyzed.

RESULTS

Among patients with microcytic or hypochromic, according to the anemia grade Ret-He gradually decreased from the non-anemia group to the severe anemia group (P<0.05); while RDW-CV was increased gradually from the mild anemia group to the severe anemia group (P<0.05); both RBC and Ret-He were increased in the thalassemia group as compared with the non- thalassemia group (P<0.05); while RDW-CV was decreased in the thalassemia group as compared with the non-thalassemia group (P<0.05); meanwhile Ret-He in the α-thalassemia group was higher than that in the β-thalassemia group. ROC curve analysis showed that combined with HbA2, the specificity was 93.51%, the sensitivity was 66.18%, the positive predictive value was 90% and the negative predictive value was 75.189% when Ret-He was truncated with 19.25 pg and RBC was truncated with 4.95×10/L.

CONCLUSION

Among patients with microcytic or hypochromic, the distribution of RBC, Ret-He and RDW-CV was different in the thalassemia group and the non-thalassemia group, and was also affected by the degree of anemia. Combined Ret-He and RBC could improve the diagnostic specificity for thalassemia, which were screened by HbA2 in patients with microcytic or hypochromic.

摘要

目的

探讨网织红细胞血红蛋白含量(Ret-He)和红细胞(RBC)在地中海贫血中的分布情况以及联合血红蛋白A2(HbA2)在小细胞低色素性贫血患者地中海贫血检测中的价值。

方法

选取2018年5月至2019年12月在我院门诊或住院的145例小细胞低色素性贫血患者,分为地中海贫血组(68例)和非地中海贫血组(77例),同时根据贫血程度将患者分为非贫血、轻度贫血、中度贫血和重度贫血四组。检测患者的Ret-He、RBC、红细胞分布宽度变异系数(RDW-CV)和HbA2,比较这些参数的分布情况,并分析Ret-He、RBC和HbA2联合检测对地中海贫血辅助诊断的敏感性、特异性等指标。

结果

在小细胞低色素性贫血患者中,根据贫血分级,Ret-He从非贫血组到重度贫血组逐渐降低(P<0.05);而RDW-CV从轻度贫血组到重度贫血组逐渐升高(P<0.05);地中海贫血组的RBC和Ret-He均高于非地中海贫血组(P<0.05);而地中海贫血组的RDW-CV低于非地中海贫血组(P<0.05);同时,α地中海贫血组的Ret-He高于β地中海贫血组。ROC曲线分析显示,当Ret-He截断值为19.25 pg且RBC截断值为4.95×10¹²/L时,联合HbA2检测,特异性为93.51%,敏感性为66.18%,阳性预测值为90%,阴性预测值为75.189%。

结论

在小细胞低色素性贫血患者中,地中海贫血组和非地中海贫血组的RBC、Ret-He和RDW-CV分布不同,且受贫血程度影响。联合Ret-He和RBC可提高对地中海贫血的诊断特异性,用于小细胞低色素性贫血患者中经HbA2筛查后的进一步诊断。

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