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目的对β-地中海贫血患者的红细胞参数进行分析,探讨红细胞参数分析对β-地中海贫血患者的临床意义。方法分析150例β-地中海贫血患者的红细胞平均容积(MCV)、红细胞平均血红蛋白含量(MCH)、红细胞平均血红蛋白浓度(MCHC)、红细胞体积分布宽度标准差(RDW-SD)、红细胞体积分布宽度变异系数(RDW-CV)及红细胞渗透脆性。结果MCV、MCH、MCHC、RDW-SD、RDW-CV及红细胞渗透脆性检测对β-地中海贫血诊断的灵敏度分别为98.7%、96.0%、87.3%、78.0%、94.7%和84.7%,相应的诊断特异度分别为88.9%、82.4%、81.5%、77.8%、78.7%和88.0%。MCV、MCH、MCHC、RDW-SD及RDW-CV并联检测的诊断灵敏度和特异度分别为99.3%和52.8%,MCV、MCH、MCHC、RDW-SD、RDW-CV及红细胞渗透脆性并联检测的诊断灵敏度和特异度分别为100%和51.0%。结论血液分析仪的五种红细胞参数并联分析对β-地中海贫血筛查有较高的诊断灵敏度,若结合红细胞渗透脆性试验,其诊断灵敏度可进一步提高。因此多参数血液分析结合红细胞渗透脆性可以满足临床对β-地中海贫血的筛查。
Objective To analyze the erythrocyte parameters of patients with β-thalassemia major and explore the clinical significance of erythrocyte parameter analysis in β-thalassemia patients. Methods The average volume of erythrocytes (MCV), average hemoglobin (MCH), average serum hemoglobin (MCHC), RDW-SD of red blood cells and width distribution of red blood cells in 150 cases of β-thalassemia were analyzed. Coefficient (RDW-CV) and erythrocyte osmotic fragility. Results The sensitivity of detection of MCV, MCH, MCHC, RDW-SD, RDW-CV and erythrocyte osmotic fragility to β-thalassemia were 98.7%, 96.0%, 87.3%, 78.0%, 94.7% and 84.7% The specificity was 88.9%, 82.4%, 81.5%, 77.8%, 78.7% and 88.0% respectively. The diagnostic sensitivity and specificity of parallel detection of MCV, MCH, MCHC, RDW-SD and RDW-CV were 99.3% and 52.8% respectively, and the diagnosis of MCV, MCH, MCHC, RDW-SD, RDW- CV and parallel detection of erythrocyte infiltration fragility Sensitivity and specificity were 100% and 51.0%. Conclusion The parallel analysis of five kinds of erythrocyte parameters in hematology analyzer has a higher diagnostic sensitivity for beta-thalassemia screening. If combined with erythrocyte infiltration fragility test, the diagnostic sensitivity can be further improved. Therefore, multi-parameter blood analysis combined with erythrocyte infiltration fragility can meet the clinical screening of β-thalassemia.