实用医学杂志 ›› 2021, Vol. 37 ›› Issue (4): 482-492.doi: 10.3969/j.issn.1006⁃5725.2021.04.013

• 临床研究 • 上一篇    下一篇

地中海贫血大人群干预方法探讨

周艳洁, 黄永全, 黄水芬
  

  1. 广西医科大学附属南宁市妇幼保健院(南宁 530011)
  • 出版日期:2021-02-25 发布日期:2021-02-25
  • 基金资助:
    广西南宁市科技局课题项目(编号:ZC20183001)

Intervention methods of thalassemia in large population

ZHOU Yanjie,HUANG Yongquan,HUANG Shuifen   

  1. Nanning Maternal and Child Health Care Hospital Affiliated to Guangxi Medical University,Nanning 530011 China

  • Online:2021-02-25 Published:2021-02-25

摘要:

目的 探讨准确、经济、高效的地中海贫血(地贫)干预方法。方法 20 525 对新婚夫妇 全部采血做血常规检查。观察组通过红细胞平均体积筛选出阳性人群做血红蛋白电泳,电泳后再选择部 分人做α地贫基因检测诊断出所有地贫风险夫妇。对照组全部做血红蛋白电泳,共设置 6 个筛查参数, 指导筛查阳性的夫妇再次抽血做α及β基因检测诊断出所有地贫风险夫妇。指导两组风险夫妇通过产前 诊断淘汰受累胎儿。结果 观察组 10 235 对夫妇中检出 392 对风险夫妇,检出率 3.83%,每对平均投入 4246 元;需跟踪 392 对夫妇;1 年内淘汰 25 例地贫儿,每例平均投入 77090 元。对照组 10290 对夫妇中检 207 对风险夫妇,检出率 2.01%,每对平均投入 11279 元;整个流程需跟踪 4 433 对夫妇;一年内淘汰 7 例地贫儿,每例平均投入 345 436 元。两组比较风险夫妇检出率、每干预 1 例地贫儿投入经费、需跟踪人数 差异显著。结论 观察组投入人力及检测经费显著少于对照组,成功干预的地贫儿却显著高于对照组, 合理选择筛查方法及流程能显著提高效率。

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Abstract:

Objective To explore an accurate,economical and efficient intervention method for thalasse⁃ mia. Methods Blood samples were collected from 20,525 newlyweds for routine blood examination. In the study group,the people with positive result of screening for mean corpuscle volume received hemoglobin electrophoresis. After electrophoresis,some people were selected for α thalassemia gene detection,and all couples at risk of thalas⁃ semia were diagnosed. In the control group,hemoglobin electrophoresis was performed and 6 screening parameters were set to guide the couples with positive screening to take blood again for α and β gene detection,and all couples at risk of thalassemia were diagnosed. The couples at risk in both groups abandoned the affected fetus through prenatal diagnosis. Results 392 couples at risk were detected in 10,235 couples in the study group,the detection rate was 3.83%,and the average cost for each couples was 4,246 yuan. 392 couples was followed up;25 thalassemia fetuses were terminated within one year,with an average cost of 77,090 yuan per case. 207 couples at risk were detected in 10,290 couples in the control group,the detection rate was 2.01%,and the average cost for each pairs was 11,279 yuan;4,433 couples were followed up;7 thalassemia fetuses were terminated within one year,with an average cost of 34,5436 yuan per case. There were significant differences between the two groups in the detection rate of risk couples,the cost of intervention for each thalassemia fetus,and the number of people to be followed up. Conclusions Use of manpower and testing cost weremarkedly less in the study group than in the control group,but the rate of successful intervention of thalassemia fetuses was significantly higher. Reasonable selection of screening methods and process can significantly improve the efficiency.

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