Chakrabarti Sudipta, Goswami Bidyut Krishna, Paul Prabir Chandra, Sarkar Supriya, Mondal Srikrishna, Das Shikha
J Indian Med Assoc. 2013 Oct;111(10):670-3.
There is a scarcity of clinical data in the field of aplastic anaemia from rural India. Present study was conducted in North Bengal Medical College to find out the clinicohaematological profile and the possible aetiological factors in patients with aplastic anaemia. The study population (n = 83) included 21 children with male to female ratio 4.93:1. Weakness was present in all cases and pallor was present in 74.70% cases. Fever, bleeding episodes and localised infection were found in 55.42%, 48.19% and 27.71% cases respectively. There was no difference in clinical manifestations between children and adult except occurrence of fever (p = 0.0365). We identified possible aetiological factors in 32.53% cases as relevant drug intake in 10.84%, exposure to chemicals in 13.25% and hepatitis in 8.43% cases. We found low mean haemoglobin (3.81 +/- 1.71 g/dl), leucocyte and platelet (3.05 +/- 1.3 and 37.30 +/- 35 x 10(3)/cmm), neutrophil (30.28 +/- 21.76%) and high lymphocyte (67.27 +/- 22.50%) in peripheral blood. At the time of presentation, aplastic anaemia was moderate in 59.04% cases, severe in 48.19% cases and mild in 4.82% cases. We estimated the prevalence of aplastic anaemia in 4 districts of West Bengal including tea garden areas was 2.98/million populations per year. It was concluded that aplastic anaemia is a major non-malignant haematological disease in this part of India, and an increasing use of chemicals in agricultural and tea garden areas might be the responsible factor. Larger population based study is suggested.
印度农村地区再生障碍性贫血领域的临床数据匮乏。本研究在北孟加拉医学院开展，旨在了解再生障碍性贫血患者的临床血液学特征及可能的病因。研究对象（n = 83）包括21名儿童，男女比例为4.93:1。所有病例均有乏力症状，74.70%的病例有面色苍白症状。发热、出血发作和局部感染分别见于55.42%、48.19%和27.71%的病例。除发热发生率外（p = 0.0365），儿童和成人的临床表现无差异。我们在32.53%的病例中确定了可能的病因，其中10.84%为相关药物摄入，13.25%为接触化学物质，8.43%为肝炎。我们发现外周血平均血红蛋白水平较低（3.81 +/- 1.71 g/dl），白细胞和血小板水平较低（3.05 +/- 1.3和37.30 +/- 35 x 10(3)/cmm），中性粒细胞水平较低（30.28 +/- 21.76%），淋巴细胞水平较高（67.27 +/- 22.50%）。就诊时，59.04%的病例为中度再生障碍性贫血，48.19%的病例为重度再生障碍性贫血，4.82%的病例为轻度再生障碍性贫血。我们估计西孟加拉邦4个地区（包括茶园地区）再生障碍性贫血的患病率为每年2.98/百万人口。研究得出结论，再生障碍性贫血是印度该地区主要的非恶性血液疾病，农业和茶园地区化学物质使用的增加可能是致病因素。建议开展更大规模的基于人群的研究。
