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目的探讨妊娠β地中海贫血妇女红细胞参数的变化及鉴别诊断中的价值。方法选取2014年7月—2015年12月在郑州人民医院进行围产期建卡的100例β地中海贫血妊娠妇女(β地贫妊娠组)、正常妊娠妇女100例(正常妊娠组)、100例妊娠期缺铁性贫血妇女作为(缺铁性贫血妊娠组),分别检测各组的平均红细胞体积(MCV)、平均红细胞血红蛋白(MCH)、网织红细胞百分率(Ret%)并进行比较分析。结果β地贫妊娠组的MCV、MCH低于正常妊娠组、缺铁性贫血妊娠组(P<0.05),β地贫妊娠组的Ret%高于正常妊娠组、缺铁性贫血妊娠组(P<0.05);Ret%鉴别诊断β地贫妊娠和缺铁性贫血妊娠的最佳临界值为1.7,灵敏度为63.00%,特异度为74.00%、ROC曲线下面积AUC值为0.841;MCV+MCH+Ret%鉴别诊断β地贫妊娠和缺铁性贫血妊娠的灵敏度为84.00%,特异度为90.00%。结论妊娠β地中海贫血妇女红细胞参数MCV、MCH、Ret%均发生显著的变化,MCV+MCH+Ret%联合应用能够显著的提高鉴别诊断β地贫妊娠和缺铁性贫血妊娠的临床价值。
Objective To investigate the changes of erythrocyte parameters in women with β-thalassemia and its value in differential diagnosis. Methods 100 cases of β-thalassemia pregnant women (β-thalassemia pregnancy group), 100 normal pregnant women (normal pregnancy group) and 100 cases of normal pregnancy were selected from July 2014 to December 2015 in Zhengzhou People’s Hospital. The pregnant women with iron deficiency anemia as (iron deficiency anemia pregnancy group), the detection of the average volume of red blood cells (MCV), mean red blood cell hemoglobin (MCH), reticulocyte percentage (Ret%) were compared and analyzed. Results The levels of MCV and MCH in the β-thalassemia pregnancy group were lower than those in the normal pregnancy group and the iron-deficiency anemia pregnancy group (P <0.05), and those in the β-thalassemia pregnancy group were higher than those in the normal pregnancy group and the iron deficiency anemia pregnancy group <0.05). The best cutoff value of differential diagnosis of β-thalassemia pregnancy and iron-deficiency anemia pregnancy was 1.7, the sensitivity was 63.00%, the specificity was 74.00%, the area under the ROC curve was 0.841; MCV + MCH + Ret% differential diagnosis of β-thalassemia pregnancy and iron deficiency anemia pregnancy sensitivity was 84.00%, the specificity of 90.00%. Conclusion The red blood cell parameters MCV, MCH and Ret% of pregnant women with β-thalassemia have significant changes. The combination of MCV + MCH + Ret% can significantly improve the clinical value of differential diagnosis of β-thalassemia and iron deficiency anemia pregnancy.