摘要
目的确定该实验室全自动毛细管电泳法检测血红蛋白A_2(HbA_2)在α地中海贫血(简称地贫)筛查中的临界值。方法收集该实验室2016年7月至2017年8月进行地贫筛查和基因诊断的外周血样本3 654例。采用全自动毛细管电泳法分析HbA_2相对含量,跨越断裂点聚合酶链反应(Gap-PCR)法和PCR结合反向点杂交(PCR-RDB)法检测地贫基因。计算灵敏度、特异度、阴性似然比和阳性似然比,绘制受试者工作特征曲线(ROC曲线)确定HbA_2筛查不同类型α地贫的最佳临界值。结果健康对照、静止型α地贫、轻型α地贫和中间型α地贫的HbA_2结果分别为(2.7±0.25)%、(2.6±0.28)%、(2.4±0.20)%和(1.4±0.69)%。HbA_2筛查静止型、轻型和中间型α地贫ROC曲线下面积分别为0.631、0.860和0.975;最佳截断值分别为<2.75%、<2.65%和<2.45%;灵敏度分别为53.7%、80.9%和91.7%;特异度分别为64.7%、77.7%和94.7%。结论全自动毛细管电泳法检测HbA_2对筛查非静止型α地贫有较好的价值,结合方法学和临床诊断需求,该实验室选择<2.7%作为HbA_2筛查α地贫的最佳截断值,以降低α地贫的漏筛率。
Objective To determine value of Henaoglobin A2 （HbA2） by the full automatic capillary electro phoresis for Screening u thalassenfia. Methods A total of 3 654 peripheral blood samples for screening and ge netic diagnosis of thalassemia in the laboratory fronl July 2016 to August 2017 were collected. The HbA2 level was analyzed by the full automatic capillary electrophoresis and the genotypes of thalassemia were detected by Gap PCR and PCR RDB. The sensitivity, sepecificity, negative likelihood ratio and positive likelihood ratio were calculated and the areas under receiver operator characteristic （ROC） curve of screening α- thalassemia by HbA2 were drawn. Results The HbA2 results of normal group,silent group,light group and intermedia group of α-thalassemia were （2.7±0.25）%,（2.6±0.28）% ,（2.4±0.20）%and（1.4±0.69）%. The optimal cutoff values of HbA2 for screening of silent u thalassemia,light u thalassemiat and intermedia u thalassemia were 2.75%,〈2.65% and 〈2.45%,respectively;the ROC curve were 0. 631,0. 860 and 0. 975 respectively;the sensitivities were 53.7%,80.9% and 91.7% ,and the specificities were 64.7%,77.7% and 94.7% respective ly. Conclusion Automatic capillary electrophoresis detection of HbAe is of better value for the screening of non silent α-thalassemia. Our laboratory selected 〈2.7 〈 as the optima cutoff value of HbA2 for screening of thalassemia,in order to reduce the missed screening rate of α- thalassemia.
作者
李育敏
覃俊龙
熊丹
阚丽娟
张水兰
汤花梅
张秀明
LI Yurnin;QIN Junlong;XIONG Dan;NAN Lijuan;ZHANG Shuilan;TANG Huamei;ZHANG Xiuming(Department of Medical Laboratory,Shenzhen Luhu People＇s Shenzhen,Guangdong 518001,China)
出处
《国际检验医学杂志》
CAS
2018年第22期2786-2789,共4页
International Journal of Laboratory Medicine
基金
深圳市医疗卫生三名工程资助项目(SZSM201601062)
