血液学指标-广州医科大学教育技术中心.pptVIP

血液学指标﹑Hb电泳、RBC脆性在地贫患者与缺铁性贫血的诊断价值 医学检验系2005届李蔼文 指导老师：孙筱放 李少英 广州市第二人民医院妇产科研究室 摘要 目的 探讨红细胞的MCV，MCH，MCHC，RDW等血液学指标、红细胞脆性、HB电泳，对地中海贫血患者及缺铁性贫血的诊断价值。方法 健康对照组30例;地中海贫血患者100例(其中α地中海贫血患者60例，β地中海贫血患者40例)，缺铁性贫血30例。全部用血细胞计数仪仪血常规测定、红细胞脆性的检测、血红蛋白电泳仪进行血红蛋白电泳分析、地贫基因检测、血清铁蛋白检测。结果 病人组血红蛋白电泳HBA，HBA2，HBF异常，其MCV，红细胞脆性均降低，与正常对照组比较有显著差异（P0.05），MCV，RBC脆性对地贫的灵敏度和特异度分别为为98%，93%及77%，80%。HBA2对α地贫，β地贫灵敏度分别为83.3%,95%。而RDW基本正常, 灵敏度为73%，但缺铁性贫血的RDW升高，灵敏度为70%。结论 1.MCV，血红蛋白电泳，红细胞脆性应用对地贫有诊断意义，可作为其简单，方便，快速，较准确的筛查方法；2.对于缺铁性贫血 ，RDW可作为先于血清铁蛋白的初筛试验，值得推广应用。 关键词 地中海贫血；MCV；MCH；RDW；红细胞脆性；血红蛋白电泳 英文摘要 [Abstract] Objective TO study the value of mean corpuscular volume(MCV),mean corpuscular hemoglobin(MCH),mean corpuscular Hemoglobin concentration(MCHC),red blood cell volume distribution width(RDW),red cell osmotic fragility test (RCOF)and Hemoglobin electrophoresis for the diagnosis of thalassemia and to comepare with IDA.Methods 30samples of the healthy people without IDA or orther anemia,and 60samples of α-thalassemia ,40 samples of β-thalassemia,30 samples of IDA,were detected by hermoatology analyzer,red cell osmotic fragility and Hb electrophoresis, genes’ test of thalassemia. Result By the Hb electrophoresis,patients’HbA,HbA2,HbF were changed,MCV,RCOF were also decending,having obvious diffenerce compared with healthy people(P0.05),the sensitivity of test were as follow: MCV was 96%, HBA2 was 83.3% for αthalassemia,95% for βthalassemia. RDW belonged normal range,it’s sensitivity was 77%.However.IDA’s RDW ascended,and it’s sensitivity for IDA was 70%.Conclusion The test of MCV,RCOF and Hb electrophoresis increases the sensitivity in the diagnosis of thalassemia, being able to become sample,quick,true tests of bolting ,IDA and Thalassemia are diffent from RDW,and RDW can be used to as a screening method before the measurement of serum ferritin,suit to be used widely. [Key words ] Thalassemia; MCV;MCH;MCHC;RDW; red cell osmotic fragility; Hemoglobin electrophoresis. 正文 地中海贫血（简称地贫），是我