目的:探讨本实验室建立的HbA2筛查α地中海贫血临界值确定方法.方法:选择2017年1月~2017年12月期间在我院接受地贫筛查及基因检测的1977名受检者,以HbA2不同的临界值分别计算筛查α地贫、标准型及中间型α地贫的敏感性、特异性、约登指数、阳性似然比、阴性似然比,分别绘制受试者工作曲线(ROC).结果: 1977例受检者中1165例地贫基因结果为阴性, 812例结果为α地贫; 812例α地贫包括静止型α地贫255例、标准型α地贫542例、中间型α地贫15例.检测结果为阴性的HbA2为(2.60±0.24)%,为α地贫的HbA2为(2.55±0.27)%,为标准型及中间型α地贫的HbA2为(2.24±0.26)%; HbA2筛查α地贫ROC曲线下面积为0.758,筛查标准型及中间型α地贫ROC曲线下面积为0.83,确定本实验室HbA2筛查α地贫临界值定为＜2.7%.结论: HbA2筛查标准型及中间型α地贫有较好的筛查性能,结合实验室和临床实际,本实验室将2.7%定为HbA2筛查α地贫的临界值.%Objective: The determination method of HbA2 screening human thalassemia was investigated. Methods: Patients accept the poor screening and genetic testing from January 2017 to December 2017 in our hospital were selected for this study, ROC curve were obtained by screening of alpha in HbA2 different threshold calculated separately to the poor and non stationary alpha group of poor sensitivity, specificity, about an index, positive likelihood ratio and negative likelihood ratio respectively. Results: In 1977 cases, 1165 cases were negative and 812 cases were insignificant. The 812 cases of chronic poverty include 255 cases of static type, 542 cases of standard type and 15 cases of intermediate type. The test results were negative in 1165 cases of HbA2 (2.60±0.24) %, static type of HbA2 (2.55 ±0.27) %, standard type and intermediate type of HbA2 (2.24 ±0.26) %. The area of HbA2 screening process was 0.758 in the static attenuation ROC curve and 0.83 in the non-static attenuation ROC curve, and the critical value of HbA2 screening process was determined to be<2.8%. Conclusion: The performance of HbA2 screening standard type and intermediate type q deficiency has good screening performance. In combination with laboratory and clinical practice, 2.7% of HbA2 was considered as the critical value of HbA2 screening process.
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