年轻胆石症患者先天性溶血性贫血的发生率。
Incidence of congenital hemolytic anemias in young cholelithiasis patients.
机构信息
Department of General Surgery, University of Baskent, Ankara 06490, Turkey.
出版信息
World J Gastroenterol. 2010 Nov 21;16(43):5457-61. doi: 10.3748/wjg.v16.i43.5457.
AIM
To clarify the incidence of congenital hemolytic anemias (CHA) in young cholelithiasis patients and to determine a possible screening test based on the results.
METHODS
Young cholelithiasis patients (< 35 years) were invited to our outpatient clinic. Participants were asked for comorbidities and family history. The number of gallstones were recorded. Blood samples were obtained to perform a complete blood count, standard Wright-Giemsa staining, reticulocyte count, hemoglobin (Hb) electrophoresis, serum lactate dehydrogenase and bilirubin levels, and lipid profile.
RESULTS
Of 3226 cholecystectomy patients, 199 were under 35 years, and 190 with no diagnosis of CHA were invited to take part in the study. Fifty three patients consented to the study. The median age was 29 years (range, 17-35 years), 5 were male and 48 were female. Twelve patients (22.6%) were diagnosed as thalassemia trait and/or ıron-deficiency anemia. Hb levels were significantly lower (P = 0.046), and mean corpuscular volume (MCV) and hematocrit levels were slightly lower (P = 0.072 and 0.082, respectively) than normal. There was also a significantly lower number of gallstones with the diagnosis (P = 0.007).
CONCLUSION
In endemic regions, for young cholelithiasis patients (age under 35) with 2-5 gallstones, the clinician/surgeon should pay attention to MCV and Hb levels as indicative of CHA.
目的
阐明年轻胆石症患者先天性溶血性贫血（CHA）的发生率，并根据结果确定可能的筛查试验。
方法
邀请年轻胆石症患者（<35 岁）到我们的门诊就诊。询问患者是否存在合并症和家族史。记录胆结石的数量。采集血样进行全血细胞计数、标准瑞氏染色、网织红细胞计数、血红蛋白（Hb）电泳、血清乳酸脱氢酶和胆红素水平以及血脂谱检查。
结果
在 3226 例胆囊切除术患者中，有 199 例年龄<35 岁，其中 190 例无 CHA 诊断，邀请他们参加研究。53 例患者同意参加研究。中位年龄为 29 岁（范围，17-35 岁），男性 5 例，女性 48 例。12 例患者（22.6%）被诊断为地中海贫血/缺铁性贫血。Hb 水平明显降低（P=0.046），平均红细胞体积（MCV）和红细胞压积水平略低（P=0.072 和 0.082）。诊断为 CHA 的患者胆结石数量也明显减少（P=0.007）。
结论
在流行地区，对于年龄<35 岁、有 2-5 个胆结石的年轻胆石症患者（age under 35），临床医生/外科医生应注意 MCV 和 Hb 水平，以提示 CHA。
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