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一组泰国东北部学童的地中海贫血症和缺铁症:与贫血症发生的关系。

Thalassemia and iron deficiency in a group of northeast Thai school children: relationship to the occurrence of anemia.

机构信息

Graduate School, Khon Kaen University, Khon Kaen, Thailand.

出版信息

Eur J Pediatr. 2010 Nov;169(11):1317-22. doi: 10.1007/s00431-010-1218-3. Epub 2010 May 19.

Abstract

UNLABELLED

The cross-sectional study assessed anemia, thalassemia, and hemoglobinopathies, as well as iron deficiency, among 190 northeastern Thai school children aged 10 to 11 years. The aim was to analyze the reasons for anemia among the group. Hemoglobin concentration and other hematological parameters were determined using an automated blood cell counter. Beta-thalassemia and other hemoglobinopathies were identified by high performance liquid chromatography (HPLC) analysis of hemoglobin. Alpha-thalassemia was identified by polymerase chain reaction (PCR) and related techniques. Iron deficiency was assessed using serum ferritin (SF) <20 ng/ml as indicator. Based on the WHO criteria, anemia was defined by hemoglobin (Hb) level <11.5 g/dl. Twenty five out of 190 children (13.2%; 95% CI = 8.7-18.8%) were anemic. Iron deficiency was found in only two out of 190 children (1.0%; 95% CI = 0.1-3.8%), but the two iron deficient children were not anemic. The proportion of thalassemia and hemoglobinopathies among the group was 61.1% (95% CI = 53.7-68.0%). As underlying reasons for anemia, thalassemia and hemoglobinopathies were found in 22 out of 25 (88.0%) anemic children. Beta-thalassemia and homozygous Hb E seem to be important, while this was less obvious for heterozygous α-thalassemia and heterozygous Hb E.

CONCLUSION

The results suggest that thalassemia and hemoglobinopathies may be major contributing factors to the occurrence of anemia in this area among the children's population.

摘要

本横断面研究评估了 190 名 10 至 11 岁泰国东北部学龄儿童的贫血、地中海贫血和血红蛋白病以及缺铁情况,旨在分析该人群贫血的原因。血红蛋白浓度和其他血液学参数使用自动血细胞计数器进行测定。采用高效液相色谱(HPLC)分析血红蛋白鉴定β-地中海贫血和其他血红蛋白病。采用聚合酶链反应(PCR)和相关技术鉴定α-地中海贫血。采用血清铁蛋白(SF)<20ng/ml 作为指标评估缺铁。根据世界卫生组织(WHO)标准,血红蛋白(Hb)水平<11.5g/dl 定义为贫血。190 名儿童中有 25 名(13.2%;95%置信区间=8.7-18.8%)贫血。仅在 190 名儿童中有 2 名(1.0%;95%置信区间=0.1-3.8%)缺铁,但这 2 名缺铁儿童无贫血。该组地中海贫血和血红蛋白病的比例为 61.1%(95%置信区间=53.7-68.0%)。作为贫血的潜在原因,在 25 名贫血儿童中有 22 名(88.0%)发现地中海贫血和血红蛋白病。β-地中海贫血和纯合 HbE 似乎很重要,杂合子α-地中海贫血和杂合子 HbE 则不那么明显。

结论

结果表明,地中海贫血和血红蛋白病可能是该地区儿童人群贫血发生的主要因素。

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