受试者工作特征曲线分析在地中海贫血筛查中的应用价值

发布时间：2018-07-08 15:02

  本文选题：地中海贫血 + 受试者工作特征曲线　； 参考：《临床儿科杂志》2017年05期

【摘要】：目的用受试者工作特征(ROC)曲线评价胎儿血红蛋白(Hb F)和HbA_2在儿童地中海贫血筛查和诊断中的临床应用价值。方法分别采用经典法(醋纤法和Singer一分钟碱变性实验)和高效液相法(HPLC)对经基因检查确诊的200例地贫患儿和62例正常对照者进行Hb F和HbA_2定量检测。以基因检测结果为金标准,采用ROC曲线分析法,分析Hb F、HbA_2曲线下面积(AUC)以及选择不同切值对应的灵敏度和特异度,确定可行性筛查方案。结果α-和β-地中海贫血组中,HPLC法定量Hb F、HbA_2值的AUC均大于对应的经典方法定量结果的AUC;β-地中海贫血组中,HPLC法定量HbA_2对应的AUC最大,为0.991。采用ROC曲线法分析得到的截断值,Hb F(≥1.05%)、HbA_2(≥3.75%)组成的联合筛查方案的诊断符合率、灵敏度、特异度可分别达到99.2%、99.0%和100.0%。结论在进行大规模β-地中海贫血筛查时,采用HPLC定量的截断值Hb F(≥1.05)、HbA_2(≥3.75)与血液学有关指标联合的筛查方案可提高筛查的灵敏度、符合率和筛查效率。
[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 伪-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，

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