[红细胞分布宽度（RDW）用于筛查地中海贫血的诊断临界值及平均红细胞体积（MCV）、平均红细胞血红蛋白含量（MCH）、血红蛋白A（HBA）与RDW的联合检测]
[Diagnostic Cut-Off Value of RDW for Screening Thalassemia and the Combined Determination of MCV, MCH, HBA and RDW].
作者信息
Song Qi-Ling, Guo Yang-Liu, He Yong-Jun, He Cheng, Zhang Ting, Cai Yan, Liu Wen, Zhu Xing-Chun, Liu Qing-Song
机构信息
Department of Prenatal Diagnosis of Affiliated Hospital of North Sichuan Medical College,Nanchong 637000, Sichuan Province, China,Laboratory of Medical Examination of North Sichuan Medical College,Nanchong 637000, Sichuan Province, China,Translational Medicine Research Center of North Sichuan Medical College,Nanchong 637000, Sichuan Province, China.
Laboratory of Medical Examination of North Sichuan Medical College,Nanchong 637000, Sichuan Province, China,Translational Medicine Research Center of North Sichuan Medical College,Nanchong 637000, Sichuan Province, China,Department of Laboratory Medicine of Affiliated Hospital, North Sichuan Medical College, Nanchong 637000, Sichuan Province, China.
出版信息
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2021 Jun;29(3):847-852. doi: 10.19746/j.cnki.issn.1009-2137.2021.03.030.
OBJECTIVE
To explore the value of red cell distribution width (RDW), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and hemoglobin (Hb) A2 combined determination scheme for screening thalassemia.
METHODS
The RDW levels of thalassemia group and healthy control group were detected and compared. The efficiency of RDW for screening thalassemia was evaluated by receiver operating characteristic (ROC) curve. The diagnostic cut-off value of RDW was also acquired by Youden index. Then, 3 groups for thalassemia screening scheme were set, including MCV+MCH+HBA , MCV+MCH+RDW(>16.0)+HBA and MCV+MCH+RDW(>15.15)+HBA . The performances of the 3 groups were evaluated through screening 621 clinical suspected cases of thalassemia.
RESULTS
The RDW level in thalassemia group was significantly higher than that in healthy control group (P<0.05). The diagnostic cut-off value for screening thalassemia was RDW>15.15, when the Youden index was the biggest among all data. The sensitivity, specificity, positive predictive value, negative predictive value, false negative rate and consistency rate of MCV+MCH+RDW(>15.15)+HBA group was 75.46%, 48.83%, 26.50%, 89.06%, 24.54%, and 54.06%, respectively.
CONCLUSION
The diagnostic cut-off value of RDW for thalassemia screening has been established. The group of MCV(<82.0 fl)+MCH(<27.0 pg)+HBA (<2.5% or ≥3.5%)+RDW(>15.15) has a best efficiency among the 3 groups to screen thalassemia.
目的
探讨红细胞分布宽度（RDW）、平均红细胞体积（MCV）、平均红细胞血红蛋白含量（MCH）及血红蛋白A2（HbA2）联合检测方案用于筛查地中海贫血的价值。
方法
检测并比较地中海贫血组和健康对照组的RDW水平，采用受试者工作特征（ROC）曲线评估RDW筛查地中海贫血的效能，通过约登指数获取RDW的诊断界值。然后设置3组地中海贫血筛查方案，分别为MCV+MCH+HbA2、MCV+MCH+RDW（>16.0）+HbA2以及MCV+MCH+RDW（>15.15）+HbA2。通过对621例临床疑似地中海贫血病例进行筛查，评估这3组方案的性能。
结果
地中海贫血组的RDW水平显著高于健康对照组（P<0.05）。在所有数据中，当约登指数最大时，筛查地中海贫血的诊断界值为RDW>15.15。MCV+MCH+RDW（>15.15）+HbA2组的灵敏度、特异度、阳性预测值、阴性预测值、假阴性率及符合率分别为75.46%、48.83%、26.50%、89.06%、24.54%和54.06%。
结论
已确定RDW用于地中海贫血筛查的诊断界值。在3组方案中，MCV（<82.0 fl）+MCH（<27.0 pg）+HbA2（<2.5%或≥3.5%）+RDW（>15.15）筛查地中海贫血的效能最佳。
Zotero 插件