[Diagnostic Cut-Off Value of RDW for Screening Thalassemia and the Combined Determination of MCV, MCH, HBA 2 and RDW]

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2021 Jun;29(3):847-852. doi: 10.19746/j.cnki.issn.1009-2137.2021.03.030.
[Article in Chinese]

Abstract
in English, Chinese

Objective: To explore the value of red cell distribution width (RDW), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and hemoglobin (Hb) A2 combined determination scheme for screening thalassemia.

Methods: The RDW levels of thalassemia group and healthy control group were detected and compared. The efficiency of RDW for screening thalassemia was evaluated by receiver operating characteristic (ROC) curve. The diagnostic cut-off value of RDW was also acquired by Youden index. Then, 3 groups for thalassemia screening scheme were set, including MCV+MCH+HBA 2, MCV+MCH+RDW(>16.0)+HBA 2 and MCV+MCH+RDW(>15.15)+HBA 2. The performances of the 3 groups were evaluated through screening 621 clinical suspected cases of thalassemia.

Results: The RDW level in thalassemia group was significantly higher than that in healthy control group (P<0.05). The diagnostic cut-off value for screening thalassemia was RDW>15.15, when the Youden index was the biggest among all data. The sensitivity, specificity, positive predictive value, negative predictive value, false negative rate and consistency rate of MCV+MCH+RDW(>15.15)+HBA 2 group was 75.46%, 48.83%, 26.50%, 89.06%, 24.54%, and 54.06%, respectively.

Conclusion: The diagnostic cut-off value of RDW for thalassemia screening has been established. The group of MCV(<82.0 fl)+MCH(<27.0 pg)+HBA 2(<2.5% or ≥3.5%)+RDW(>15.15) has a best efficiency among the 3 groups to screen thalassemia.

题目: RDW筛查地中海贫血诊断界值的建立及其与MCV、MCH、HBA 2联合筛查的价值.

目的: 探讨红细胞分布宽度（RDW）与红细胞平均体积（MCV）、平均红细胞血红蛋白含量（MCH）、血红蛋白（Hb）A2联合筛查方案在地中海贫血（简称地贫）筛查中的应用价值.

方法: 检测地贫患者和体检健康者（健康对照组）的RDW水平，比较两组RDW水平变化。绘制受试者工作曲线（ROC），计算约登指数，评价RDW的诊断性能，建立RDW筛查地贫诊断界值。另外选取621例疑似地贫患者，设置3组筛查方案，分别为MCV+MCH+HBA 2、MCV+MCH+RDW（>16.0）+HBA 2和MCV+MCH+RDW（>15.15）+HBA 2，对3组筛查方案进行性能评价.

结果: 地贫患者RDW水平明显高于体检健康者（健康对照组），差异具有统计学意义（P<0.05）。选用RDW>15.15作为筛查地贫的诊断界值。MCV+MCH+RDW（>15.15）+HBA 2地贫筛查方案的敏感性、特异性、阳性预测值、阴性预测值、漏诊率、诊断符合率分别为75.46%、48.83%、26.50%、89.06%、24.54%和54.06.

结论: 建立了RDW筛查地贫的诊断界值，在MCV（<82.0 fl）+MCH（<27.0 pg）+HBA 2（<2.5%或≥3.5%）+RDW（>15.15）筛查方案中将RDW>15.15作为诊断界值在3种地贫筛查方案中具有较好的筛查价值.

MeSH terms

  • Erythrocyte Indices*
  • Hemoglobin A2 / analysis
  • Humans
  • Mass Screening
  • Research
  • Thalassemia* / diagnosis

Substances

  • Hemoglobin A2