Objective To explore the value of mean corpuscular volume(MCV),mean corpuscular hemoglobin(MCH),mean corpuscular hemoglobin concentration(MCHC)and hemoglobin A2(HbA2)in screening for alpha-thalassemia(abbreviated as α-thalassemia).Methods From January 2019 to December 2020 in our hospital,223 pa-tients diagnosed with α-thalassemia and 689 controls with negative gene diagnosis of thalassemia were selected as the research subjects.The results of blood routine examination and hemoglobin electrophoresis were analyzed.Receiver op-erating curve(ROC)was used to evaluate the screening performance of various indicators for α-thalassemia.Results Among the 223 patients with α-thalassemia,minor α-thalassemia was the most common,with the-SEA/αα genotype as the main type.The values of MCV,MCH,MCHC and HbA2 in α-thalassemia patients were all lower than those in non-thalassemia control group,and the differences were statistically significant(P＜0.01).When MCV,MCH,MCHC and HbA2 were used as screening indexes of α-thalassemia,the area under ROC curve was 0.94,0.96,0.90 and 0.79,re-spectively,and the sensitivity of was 87.44％,92.83％,83.41％and 70.40％,respectively.The specificity was 89.55％,90.13％,81.42％,75.76％,respectively.The screening efficiency of HbA2 for different types of α-thalasse-mia was different.The area under ROC curve of static α-thalassemia,minor α-thalassemia and HbH disease was 0.68,0.87 and 1.00 respectively.Combined with clinical needs,it is recommended that MCV＜84.45 fL,MCH＜28.45 pg,MCHC＜330.30 g/L and HbA2＜2.85％as the screening criteria for α-thalassemia in our laboratory.Conclusion The sensitivity and specificity of MCV,MCH and MCHC were excellent for screening α-thalassemia.HbA2 can be used as independent screening index for HbH disease in Guilin,but for static α-thalassemia and minor α-thalassemia,it may cause missed detections.If necessary,gene diagnosis can be performed directly to improve the accuracy of the diagnosis of α-thalassemia and reduce missed screening.
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