实用医学杂志 ›› 2022, Vol. 38 ›› Issue (13): 1676-1679.doi: 10.3969/j.issn.1006⁃5725.2022.13.021

• 医学检查与临床诊断 • 上一篇    下一篇

比较两种血红蛋白A2测定方法对轻型 α地中海贫血的诊断性能

王展强 杨华文 黄基伟 李亚红 曹东林 雷达    

  1. 广东省第二人民医院检验医学部(广州 510317)

  • 出版日期:2022-07-10 发布日期:2022-07-10
  • 通讯作者: 雷达 E⁃mail:50119528@qq.com
  • 基金资助:
    广州市科技计划项目资助项目(编号:202108050520130002)

Diagnostic performances of two hemoglobin A2 assays for α ⁃ thalassemia:A comparative study 

WANG Zhanqiang,YANG Huawen,HUANG Jiwei,LI Yahong,CAO Donglin,LEI Da.   

  1. Department of Laboratory Medi⁃ cine,Guangdong Second Provincial General Hospital,Guangzhou 510317,China 

  • Online:2022-07-10 Published:2022-07-10
  • Contact: LEI Da E⁃mail:50119528@qq.com

摘要:

目的 比较高效液相色谱法和毛细管区带电泳测定血红蛋白 A2(hemoglobin A2,HbA2)对 轻型 α 地贫的诊断性能。方法 选取 2019 1 月到 2021 12 月在广东省第二人民医院进行 α 地贫筛查 的患者纳入研究,收集所有患者 HbA2 和地贫基因结果等临床信息,根据地贫基因结果分为对照组和轻型 α 地贫组,分析不同组间上述指标的差异,使用 ROC 曲线评价并比较高效液相色谱法和毛细管区带电泳检测 HbA2 对轻型 α 地贫的诊断性能及截断值。结果 与对照组相比,轻型 α 地贫组的 HbA2 在高效液 相色谱法[(2.78 ± 0.39)% vs.(2.57 ± 0.21)%,P < 0.001)]和毛细管区带电泳[(2.62 ± 0.46)% vs.(2.34 ± 0.31)%,P < 0.001)]检测的人群中均降低。使用高效液相色谱法检测 HbA2 时,其诊断轻型 α 地贫 ROC 曲线的 AUC 0.715(95%CI:0.682 ~ 0.747,P < 0.001),截断值为 2.8%,对应的灵敏度和特异度分别为 82.6% 55.7%;使用毛细管区带电泳检测 HbA2 时,其诊断轻型 α 地贫 ROC 曲线的 AUC 0.786(95%CI 0.751 ~ 0.821,P < 0.001),截断值为 2.6%,对应的灵敏度和特异度分别为 91.1% 57.4%。结论 毛细管 区带电泳检测HbA2对轻型α 地贫的诊断性能优于高效液相色谱法。

关键词: 毛细管区带电泳,  , 高效液相色谱法,  , 血红蛋白A2,  , α 地中海贫血

Abstract:

Objective To compare the diagnostic performances of high performance liquid chromatogra⁃ phy and capillary zone electrophoresis in the determination of HbA2 in α ⁃thalassemia. Methods The patients underwent α ⁃thalassemia screening in the Guangdong Second Provincial General Hospital from January 2019 to December 2021 were engaged in this study for the gathering of their clinical data such as HbA2 and thalassemia gene test results. The patients were divided into control group and α⁃thalassemia group according to the results of thalassemia gene detection. The indexes of the two groups were analyzed. The ROC was used to evaluate and com⁃ pare the diagnostic performances and cut⁃off point of HbA2 in α⁃thalassemia detected by high performance liquid chromatography and capillary zone electrophoresis. Results HbA2 in the α⁃thalassemia group was both significantly decreased when detected by both high performance liquid chromatography,as compared to the control group [(2.78 ± 0.39)% vs.(2.57 ± 0.21)%,P < 0.001)]or capillary zone electrophoresis[(2.62 ± 0.46)% vs.(2.34 ± 0.31)%,P < 0.001)]. When detected by high performance liquid chromatography,the AUC of the HbA2 of ROC was 0.715(95%CI:0.682 ~ 0.747,P < 0.001)and the cut⁃off point was 2.8%,with sensitivity and specificity of 82.6% and 55.7%,respectively,while detected by capillary zone electrophoresis,the AUC of the HbA2 of ROC was 0.786(95%CI:0.751 ~ 0.821,P < 0.001)and the cut⁃off point was 2.6%,with sensitivity and specificity of 91.1% and 57.4%,respectively. Conclusions The capillary zone electrophoresis is better than the high perfor⁃ mance liquid chromatography when used for diagnosing α⁃thalassemia.

Key words:

capillary zone electrophoresis, HPLC, hemoglobin A2, α?thalassemia trait