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目的探讨平均红细胞体积(MCV)和平均血红蛋白浓度(MCH)在地贫筛查中的诊断截断值及应用价值。方法在南宁农村育龄夫妇地贫筛查中以血清铁蛋白正常的经基因分析确认的153例健康成人、55例β地贫杂合子、76例α地贫1、59例α地贫2和18例不贫血或只有轻度贫血的αβ复合型地贫MCV和MCH通过受试者工作曲线确定其地贫筛查截断值,并以确定的截断值分析其临床诊断意义。结果诊断地贫的截断值分别为MCV≤78.25fl和MCH≤25.65pg,此截断值的敏感度和特异度分别为MCV:85.6%和94.8%,MCH:82.7%和94.8%。55例β地贫杂合子和18例复合型地贫MCV和MCH均低于上截断值,76例α地贫1除1例MCH高于截断值外其它均低于截断值,59例α地贫2中30例MCV低于上截断值,24例MCH低于上截断值,而健康成人中分别有8例MCH和/或MCV低于上截断值。结论以MCV≤78.25fl和MCH≤25.65pg作为地贫表型阳性截断值进行地贫筛查有较高的应用价值。
Objective To investigate the diagnostic cutoff value and its application value of mean corpuscular volume (MCV) and mean hemoglobin concentration (MCH) in thalassemia screening. Methods A total of 153 healthy adults, 55 cases of β-thalassemia heterozygotes, 76 cases of α-thalassemia and 1 case of α-thalassemia 2 and 18 Cases of anemia or anemia only αβ complex thalassemia MCV and MCH through the receiver operating curve to determine the thalassemia screening cut-off value, and to determine the cut-off value of its clinical significance. Results The cutoff values of thalassemia were MCV≤78.25fl and MCH≤25.65pg respectively. The sensitivity and specificity of this cutoff were 85.6% and 94.8% for MCV, 82.7% and 94.8% for MCH. 55 cases of β-thalassemia heterozygote and 18 cases of complex thalassemia MCV and MCH were lower than the cut-off value, 76 cases of α-thalassemia 1 except 1 case of MCH higher than the cut-off value were lower than the cut-off value, 59 cases of α Thirty cases of MCV in the poor 2 were below the upper cut-off value, 24 of the MCHs were below the upper cut-off value, whereas 8 of the healthy adults had MCH and / or MCV below the upper cut-off value, respectively. Conclusion The screening of thalassemia with MCV≤78.25fl and MCH≤25.65pg as the positive cutoff of thalassemia is of high value.