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目的探讨平均红细胞体积(MCV)、平均红细胞血红蛋白含量(MCH)检测在筛查妊娠合并轻型地中海贫血(地贫)中的价值。方法 1514例孕妇在首次产前检查时,同时检查外周血MCV、血红蛋白浓度(Hb)、MCH及血红蛋白电泳等指标,依据首次产前检查时血常规及血红蛋白电泳结果分3组:Ⅰ组127例:Hb<100g/L伴血红蛋白电泳异常;Ⅱ组69例:Hb<100g/L而血红蛋白电泳正常;对照组1318例:Hb>100g/L及血红蛋白电泳正常;以基因诊断作为地贫诊断金标准。结果Ⅰ组MCV及MCH最低,明显低于Ⅱ组和对照组(P<0.01),而Ⅱ组与对照组无显著性差异(P>0.05)。MCV及MCH检测筛查地贫与基因诊断结果比较:灵敏度(Se)98.06%、特异度(Sp)72.04%、假阳性率0.28、假阴性率0.02、准确度90.31%、阳性预测值79.53%、阴性预测值90.30%、阳性似然比3.50、阴性似然比0.028。结论轻型地贫者有MCV、MCH降低的特征,临床上检测MCV、MCH筛查妊娠合并轻型地贫,其灵敏度高,且特异度也较高,假阳性率和假阴性率低。方法简便、实用、经济。可作为基层医院轻型地贫的筛查指标。
Objective To investigate the value of mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) in the screening of pregnant women with thalassemia of. Methods 1514 pregnant women at the time of first prenatal examination, while checking the peripheral blood MCV, hemoglobin (Hb), MCH and hemoglobin electrophoresis and other indicators, according to the first prenatal examination of blood and hemoglobin electrophoresis results were divided into three groups: Ⅰ group of 127 cases : Hb <100g / L with hemoglobin electrophoresis abnormalities; Ⅱ group 69 cases: Hb <100g / L and normal hemoglobin electrophoresis; control group 1318 cases: Hb> 100g / L and hemoglobin electrophoresis; Gene diagnosis as the gold standard for diagnosis of thalassemia . Results The lowest MCV and MCH in group Ⅰ were significantly lower than those in group Ⅱ and control (P <0.01), but there was no significant difference between group Ⅱ and control (P> 0.05). The results of MCV and MCH detection of thalassemia and gene diagnosis showed that the sensitivity was 98.06%, the specificity was 72.04%, the false positive rate was 0.28, the false negative rate was 0.02, the accuracy was 90.31%, the positive predictive value was 79.53% The negative predictive value was 90.30%, the positive likelihood ratio was 3.50, and the negative likelihood ratio was 0.028. Conclusions The features of MCV and MCH in patients with mild to poor type are mild. The detection of MCV and MCH in pregnancy is associated with mild thalassemia. The sensitivity and specificity are high, and the false positive rates and false negative rates are low. The method is simple, practical and economical. It can be used as a screening index for light thalassemia in primary hospitals.