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目的①总结出MCH(红细胞平均血红蛋白含量)筛查α-地中海贫血的临界值;②探讨MCH在新生儿脐带血α-地中海贫血(简称α-地贫)筛查中的临床价值。方法采集来我库储存的363例新生儿脐带血,进行血红蛋白电泳检测和家系调查,诊断出α-地贫63例和非地贫300例,将此363例新生儿脐带血进行MCV(红细胞平均体积)、MCH检测(送检时间超过2h),分别分析MCV和MCH检测α-地贫的灵敏度和特异度等评价指标。结果①MCH筛查地中海贫血的临界值为34pg。②MCV、MCH法筛查地中海贫血的灵敏度、特异度、准确度、阳性预测值、阴性预测值分别为71.4%和77.8%、84.6%和93.0%、82.3%和90.3%、49.5%和70.0%、93.4%和95.6%。结论 MCH比MCV更稳定,在血液标本送检时间超过2h时,应采用MCH法筛查α-地贫。
Objectives ① Summarize the critical value of MCH (erythrocyte mean hemoglobin content) screening α-thalassemia; ② explore the clinical value of MCH in the screening of neonatal umbilical cord blood α-thalassemia (a-thalassemia). Methods Thirty-six neonates with umbilical cord blood collected from our hospital were collected for hemoglobin electrophoresis and pedigree investigation. 63 cases of α-thalassemia and 300 cases of non-thalassemia were diagnosed. The cord blood of 363 newborn infants were tested for MCV Volume), MCH test (inspection time more than 2h), respectively, the sensitivity and specificity of MCV and MCH detection of α-thalassemia indicators such as evaluation. Results ① The cut-off value of MCH screening for thalassemia was 34pg. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of MCV and MCH screening for thalassemia were 71.4% and 77.8%, 84.6% and 93.0%, 82.3% and 90.3%, 49.5% and 70.0% respectively, 93.4% and 95.6%. Conclusions MCH is more stable than MCV. When the blood samples are sent for more than 2 hours, the MCH method should be used to screen α-thalassemia.