發(fā)布時間：2018-07-08 15:02

  本文選題：地中海貧血 + 受試者工作特征曲線��； 參考：《臨床兒科雜志》2017年05期

【摘要】：目的用受試者工作特征(ROC)曲線評價胎兒血紅蛋白(Hb F)和HbA_2在兒童地中海貧血篩查和診斷中的臨床應用價值。方法分別采用經典法(醋纖法和Singer一分鐘堿變性實驗)和高效液相法(HPLC)對經基因檢查確診的200例地貧患兒和62例正常對照者進行Hb F和HbA_2定量檢測。以基因檢測結果為金標準,采用ROC曲線分析法,分析Hb F、HbA_2曲線下面積(AUC)以及選擇不同切值對應的靈敏度和特異度,確定可行性篩查方案。結果α-和β-地中海貧血組中,HPLC法定量Hb F、HbA_2值的AUC均大于對應的經典方法定量結果的AUC;β-地中海貧血組中,HPLC法定量HbA_2對應的AUC最大,為0.991。采用ROC曲線法分析得到的截斷值,Hb F(≥1.05%)、HbA_2(≥3.75%)組成的聯(lián)合篩查方案的診斷符合率、靈敏度、特異度可分別達到99.2%、99.0%和100.0%。結論在進行大規(guī)模β-地中海貧血篩查時,采用HPLC定量的截斷值Hb F(≥1.05)、HbA_2(≥3.75)與血液學有關指標聯(lián)合的篩查方案可提高篩查的靈敏度、符合率和篩查效率。
[Abstract]:Objective to evaluate the clinical value of fetal hemoglobin (HB F) and HbAsphag2 in the screening and diagnosis of children with thalassemia. Methods 200 children with thalassemia confirmed by gene examination and 62 normal controls were quantitatively detected for HB F and HBA _ 2 by classical method (vinegar fiber method and Singer one-minute alkaline denaturation test) and high performance liquid phase (HPLC). With the result of gene detection as gold standard, using ROC curve analysis, the area (AUC) under HbFV HbA2 curve was analyzed, and the sensitivity and specificity corresponding to different shear values were selected to determine the feasible screening scheme. Results in 偽-and 尾-thalassemia groups, the AUC of HbF- HbA2 by HPLC was higher than that of AUC by classical method, and the AUC corresponding to HbA-2 by HPLC was 0.991in 尾 -thalassemia group. The diagnostic coincidence rate, sensitivity and specificity of the combined screening program composed of HbA2 (鈮，

本文編號：2107811