Srisupundit Kasemsri, Piyamongkol Wirawit, Tongsong Theera
Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Am J Hematol. 2008 Dec;83(12):908-10. doi: 10.1002/ajh.21287.
The objective of this study was to compare red blood cell indices among normal, alpha-thalassemia-1 trait, and hemoglobin (Hb) Bart's fetuses at mid-pregnancy. A total of 87 pregnancies (88 fetuses) at risk of homozygous alpha-thalassemia-1, who underwent cordocentesis including the measurement of Hb level and red blood cell indices of fetuses at 18-22 weeks of gestation at Maharaj Nakorn Chiang Mai Hospital, were recruited into this study. The final outcome was based on the fetal DNA analysis using PCR technique for SEA type alpha-thalassemia-1. Fetuses were divided into three groups: normal, alpha-thalassemia-1 trait, and homozygous alpha-thalassemia-1 (Hb Bart's disease). The mean gestational age of the 87 pregnant women recruited into the study was 18.7 +/- 0.8 weeks. According to the DNA analysis, the incidence of Hb Bart's disease, alpha-thalassemia-1 trait, and normal fetuses were 29.5%, 45.5%, and 25%, respectively. The mean Hb level, mean corpuscular volume, mean corpuscular Hb, and mean cell Hb concentration were significantly different in all three groups of fetuses. Moreover, these differences were also found among fetuses with the alpha-thalassemia-1 trait and those that were normal. Ninety-two percent of fetuses with Hb Bart's disease had some degree of anemia at mid-pregnancy. However, two Hb Bart's fetuses did not have anemia. Furthermore, two fetuses in the alpha-thalassemia-1 trait group were mildly anemic, but most (95%) were not. There is a highly significant difference in red blood cell indices among normal, alpha-thalassemia-1 trait, and Hb Bart's fetuses, and most fetuses with Hb Bart's disease have some degree of anemia from mid-pregnancy.
本研究的目的是比较孕中期正常胎儿、α-地中海贫血-1特征胎儿和血红蛋白（Hb）Bart胎儿的红细胞指数。共有87例有纯合子α-地中海贫血-1风险的妊娠（88例胎儿），在清迈玛哈拉吉医院于妊娠18 - 22周接受了脐血穿刺术，包括测量胎儿的血红蛋白水平和红细胞指数，被纳入本研究。最终结果基于使用聚合酶链反应（PCR）技术对SEA型α-地中海贫血-1进行的胎儿DNA分析。胎儿被分为三组：正常胎儿、α-地中海贫血-1特征胎儿和纯合子α-地中海贫血-1（Hb Bart病胎儿）。纳入研究的87名孕妇的平均孕周为18.7±0.8周。根据DNA分析，Hb Bart病胎儿、α-地中海贫血-1特征胎儿和正常胎儿的发生率分别为29.5%、45.5%和25%。三组胎儿的平均血红蛋白水平、平均红细胞体积、平均红细胞血红蛋白含量和平均红细胞血红蛋白浓度均有显著差异。此外，α-地中海贫血-1特征胎儿和正常胎儿之间也存在这些差异。92%的Hb Bart病胎儿在孕中期有一定程度的贫血。然而，有两名Hb Bart病胎儿没有贫血。此外，α-地中海贫血-1特征组中有两名胎儿轻度贫血，但大多数（95%）没有贫血。正常胎儿、α-地中海贫血-1特征胎儿和Hb Bart病胎儿的红细胞指数存在高度显著差异，且大多数Hb Bart病胎儿从孕中期开始有一定程度的贫血。
