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埃及中间型β地中海贫血和重型β地中海贫血患者的临床病理与放射学研究:与并发症及治疗反应的关系

Clinicopathological and radiological study of Egyptian β-thalassemia intermedia and β-thalassemia major patients: relation to complications and response to therapy.

作者信息

Mokhtar Galila M, Tantawy Azza A G, Adly Amira A M, Ismail Eman A R

机构信息

Department of Pediatric, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

出版信息

Hemoglobin. 2011;35(4):382-405. doi: 10.3109/03630269.2011.598985.

Abstract

The clinico epidemiological characteristics, frequency of complications, and response to various therapeutic modalities in 80 Egyptian β-thalassemia intermedia (β-TI) patients were compared with 70 β-thalassemia major (β-TM) patients. β-Thalassemia intermedia patients had a higher incidence of left atrium dilatation, right ventricular dilatation and pulmonary hypertension, whereas, β-TM patients showed a higher incidence of left ventricular (LV) dilatation, restrictive LV filling and impaired LV contractility, with an overall higher incidence of heart disease (p <0.001). Short stature, delayed puberty, osteoporosis, bone fractures, diabetes mellitus and viral hepatitis was frequently observed in β-TM patients compared with β-TI patients (p <0.05). Administration of hydroxyurea (HU) alone was associated with significant improvement in hematological parameters and quality of life for β-TI patients. In conclusion, the risk of complications still burdens the life of Egyptian thalassemia patients and their frequency varies between β-TI and β-TM. We provide evidence that calls for the use of HU in β-TI patients.

摘要

将80例埃及中间型β地中海贫血(β-TI)患者的临床流行病学特征、并发症发生率及对各种治疗方式的反应与70例重型β地中海贫血(β-TM)患者进行了比较。中间型β地中海贫血患者左心房扩张、右心室扩张和肺动脉高压的发生率较高,而重型β地中海贫血患者左心室(LV)扩张、左心室充盈受限和左心室收缩功能受损的发生率较高,心脏病的总体发生率也较高(p<0.001)。与中间型β地中海贫血患者相比,重型β地中海贫血患者更常出现身材矮小、青春期延迟、骨质疏松、骨折、糖尿病和病毒性肝炎(p<0.05)。单独使用羟基脲(HU)可使中间型β地中海贫血患者的血液学参数和生活质量得到显著改善。总之,并发症风险仍然给埃及地中海贫血患者的生活带来负担,其发生率在中间型β地中海贫血和重型β地中海贫血之间有所不同。我们提供的证据表明,中间型β地中海贫血患者需要使用羟基脲。

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