摘要
目的探讨脐带血血常规及网织红细胞相关参数在α-珠蛋白生成障碍性贫血(简称地贫)中的诊断价值。方法采用Sysmex XT-4000i全自动血细胞分析仪对729例新生儿脐带血进行血常规及网织红细胞相关参数分析,采用美国海伦娜SPIFE3000电泳仪对上述脐带血进行血红蛋白(Hb)电泳检测,将出现Hb Bart′s带的105例α-地贫新生儿作为电泳异常组,无Hb Bart′s带的624例新生儿作为电泳正常组,电泳正常而Hb水平低于145 g/L的217例新生儿作为电泳正常贫血组,电泳正常而Hb水平大于或等于145 g/L的407例新生儿作为电泳正常对照组。对各组Hb、红细胞计数、平均红细胞体积(MCV)、平均红细胞血红蛋白含量(MCH)和网织红细胞相关参数[网织红细胞百分比、网织红细胞绝对值、低荧光强度网织红细胞、中荧光强度网织红细胞、高荧光强度网织红细胞、网织红细胞血红蛋白含量(Ret-He)]进行比较分析,并采用受试者工作特征曲线(ROC曲线)评价上述各项参数的诊断效能。结果筛选出诊断效能较高的参数为MCH、MCV、Ret-He,其在诊断α-地贫时的ROC曲线下面积达0.950、0.930、0.936,具有较高的诊断效能,其他指标诊断效能不高。MCH的cut off值为31.45 pg时,其诊断α-地贫的灵敏度为0.848,特异度为0.942;MCV的cut off值为96.80 fL时,其诊断α-地贫的灵敏度为0.810,特异度为0.958;Ret-He的cut off值为28.05 pg时,其诊断α-地贫的灵敏度为0.876,特异度为0.888。结论新生儿脐带血MCV、MCH及网织红细胞参数Ret-He等在鉴别诊断α-地贫中具有很高的诊断效能,可作为筛查新生儿α-地贫的有效指标,可在基层广泛推广使用。
Objective To explore the diagnostic value of cord blood routine and reticulocyte parameters inα-thalassemia.Methods The blood routine and reticulocyte parameters of a total of 729 newborns were analyzed by Sysmex XT-4000i automatic hematology analyzer,and Hemoglobin(Hb)electrophoresis detection was performed on the above cord blood by Helena SPIFE3000 electrophoresis instrument,105 newborns with Hb Bart′s bands were classified as abnormal electrophoresis group,624 newborns without Hb Bart′s band were classified as normal electrophoresis group,217 newborns with Hb lower than 145 g/L were classified into electrophoretic anemia group,and 407 newborns with Hb higher than or equal to 145 g/L was classified into normal electrophoresis control group.Hb,erythrocyte count,mean corpuscular volume(MCV),mean corpuscular hemoglobin content(MCH)and reticulocyte relative parameters including reticulocyte percentage,reticulocyte absolute value,low fluorescence intensity reticulocyte,medium fluorescence intensity reticulocyte,high fluorescence intensity reticulocyte,reticulocyte hemoglobin content(Ret-He)were statistically analyzed,and the area under receiver operating characteristic curve(ROC curve)was used to analyze the diagnostic efficiency.Results The parameters of MCH,MCV and Ret-He with relatively high diagnostic efficiency were screened,and it was found that the area under the ROC curve of MCH,MCV and Ret-He reached 0.950,0.930 and 0.936 in the diagnosis ofα-thalassemia,and they had high diagnostic efficiency,while the diagnostic efficiency of other indexes was not high.When the cut-off value of MCH was 31.45 pg,the sensitivity and specificity were 0.848 and 0.942,respectively.When the cut-off value of MCV is 96.80 fL,the sensitivity and specificity were 0.81 and 0.958 respectively.When the cut-off value of Ret-He was 28.05 pg,the sensitivity and specificity were 0.876 and 0.888 respectively.Conclusion MCV,MCH and reticulocyte parameter Ret-He and so on of neonatal cord blood have high diagnostic efficiency in the differential diagnosis ofα-thalassemia,and they could be used as effective indexes for screening neonatalα-thalassemia,and can be widely promoted at the grass-roots level.
作者
莫超越
杨珍琳
邝俊健
MO Chaoyue;YANG Zhenlin;KUANG Junjian(Department of Clinical Laboratory;Xinglong Community Service Center;Department of Clinical Pharmacy,Wuzhou Hospital of Traditional Chinese Medicine,Wuzhou,Guangxi 543002,China)
出处
《国际检验医学杂志》
CAS
2021年第16期1941-1946,共6页
International Journal of Laboratory Medicine
基金
广西壮族自治区卫生和计划生育委员会自筹经费科研课题(Z20180449)。
