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目的探讨产前脐血MCV、MCH特点及参考范围,比较MCV、MCH诊断α地中海贫血(地贫)的价值。方法对1 563例孕妇经腹行脐带穿刺术,取脐血进行血细胞和地贫基因分析,比较MCV、MCH筛查α地贫的灵敏度和特异性等指标。结果α地贫组、正常组脐血MCV和MCH分别为(106.9±10.9)fl、(121.7±8.5)fl和(33.4±4.7)pg、(41.3±2.8)pg,产前脐血MCV和MCH的参考范围为(105.0～138.4)fl和(35.8～46.8)pg。MCH筛查α地贫的灵敏度、特异度、准确度、阳性预测值和阴性预测值均高于MCV,其筛查中间型、重型α地贫灵敏度为100%。结论产前脐血MCV、MCH的参考范围明显高于新生儿及成人,有必要建立参考范围;产前脐血MCV、MCH检测可为α地贫临床诊断提供依据,MCH筛查α地贫优于MCV。
Objective To investigate the characteristics and reference range of MCV and MCH in prenatal cord blood and to compare the diagnostic value of MCV and MCH in the diagnosis of thalassemia. Methods A total of 1 563 pregnant women underwent umbilical cord puncture and umbilical cord blood for hematopoietic and thalassemia gene analysis. The sensitivity and specificity of screening for alpha thalassemia by MCV and MCH were compared. Results The levels of MCV and MCH were (106.9 ± 10.9) fl, (121.7 ± 8.5) fl and (33.4 ± 4.7) pg, (41.3 ± 2.8) pg respectively in the α-thalassemia group and the normal group The reference range is (105.0 ~ 138.4) fl and (35.8 ~ 46.8) pg. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of MCH screening for α-thalassemia were higher than those for MCV screening, and the sensitivity of screening for intermediate and severe α-thalassemia was 100%. Conclusion The reference range of MCV and MCH in prenatal umbilical cord blood is obviously higher than that in neonates and adults, so it is necessary to establish the reference range. The detection of MCV and MCH in prenatal umbilical cord blood can provide a basis for the clinical diagnosis of alpha thalassemia. At MCV.