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目的:探讨红细胞参数在早孕患者β地中海贫血筛查中的应用价值。方法:收集我院2015年1月至2015年3月产科门诊85例早孕合并小细胞低色素性贫血患者资料。根据β-地中海贫血基因检测和血清铁蛋白检测结果,分为缺铁性贫血组(n=42)和地中海贫血组(n=43)。绘制患者检测特征曲线分析RBC、Hb、MCV、MCH、RDW-CV、RDW-SD对早孕患者β地中海贫血的诊断价值。结果:地中海贫血组患者RBC、Hb、MCV、MCH、RDW-CV、RDW-SD均显著高于缺铁性贫血组。Hb、MCV、RDW-CV、RDW-SD受试者工作特征曲线下面积分别为0.961(0.924-0.998)、0.960(0.913-1.000)、0.888(0.815-0.961)、0.843(0.760-0.926)。当Hb临界值为88.0g/L时,敏感性和特异性分别为88.4%和95.2%。当MCV临界值为60.0fl时,敏感性和特异性分别为100.0%和88.1%。当Hb、MCV分别取临界值为88.0 g/L和60.0fl时,联合敏感性为88.4%,联合特异性为99.4%。结论:Hb、MCV指标可用于早孕患者β地中海贫血早期诊断;Hb、MCV联合试验可提高敏感性和特异性。
Objective: To investigate the value of erythrocyte parameters in beta thalassemia screening in early pregnancy. Methods: From January 2015 to March 2015 in our hospital, 85 cases of obstetric patients with early-pregnancy microcytic hypochromic anemia were collected. According to the β-thalassemia gene test and serum ferritin test results, the patients were divided into iron-deficiency anemia group (n = 42) and thalassemia group (n = 43). The diagnostic value of RBC, Hb, MCV, MCH, RDW-CV and RDW-SD in the diagnosis of β-thalassemia in the first trimester of pregnant women was drawn. Results: The levels of RBC, Hb, MCV, MCH, RDW-CV and RDW-SD in patients with thalassemia were significantly higher than those in patients with iron deficiency anemia. The area under the working characteristic curve of Hb, MCV, RDW-CV and RDW-SD subjects were 0.961 (0.924-0.998), 0.960 (0.913-1.000), 0.888 (0.815-0.961) and 0.843 (0.760-0.926), respectively. When the critical value of Hb was 88.0g / L, the sensitivity and specificity were 88.4% and 95.2%, respectively. Sensitivity and specificity were 100.0% and 88.1%, respectively, when the MCV cutoff was 60.0 fl. When the critical values of Hb and MCV were 88.0 g / L and 60.0 fl, the combined sensitivity was 88.4% and the combined specificity was 99.4%. Conclusion: The Hb and MCV indexes can be used for the early diagnosis of β-thalassemia in early pregnant women. The combination of Hb and MCV can improve the sensitivity and specificity.