Chopra G S, Nair V, Gupta P K, Mishra D K, Sharma A, Mathew O P
Brigadier Administration, Armed Forces Medical College, Pune.
Senior Advisor (Medicine & Clinical Haematology), Army Hospital (R & R), New Delhi.
Med J Armed Forces India. 2008 Oct;64(4):311-4. doi: 10.1016/S0377-1237(08)80005-6. Epub 2011 Jul 21.
Thalassaemia and other structural haemoglobinopathies are the major genetic disorders prevalent in certain parts of the world including India. This study presents the pattern of haemoglobinopathies amongst the referred patients of anaemia in a two-year period.
A total of 1032 patients were studied during a two-year period for anaemia investigation. Haematological indices, sickling test and haemoglobin electrophoresis with quantification of the bands was done in all cases.
Out of 1032 cases, 774 (75%) were normal and 258 (25%) cases had abnormal haemoglobin pattern. Of the 258 abnormal cases, 136 (53%) were males and 122 (47%) were females. Of all cases of anaemia 370 (36%) were microcytic hypochromic, 237 (23%) macrocytic, 151 (15%) were dimorphic and the rest (26%) had normocytic normochromic picture. 82% of microcytic hypochromic anaemias had reduced serum iron and elevated total iron binding capacity (TIBC), whereas 85% had decreased serum ferritin levels. Spectrum of haemoglobinopathies prevalent were β-Thalassemia trait (17%), followed by sickle cell trait (2.3%). Other haemoglobinopathies in descending order of frequency were sickle cell disease (1.7%), Hb D trait (1%), Hb E trait (0.8%), sickle cell - β thalassemia, Hb E disease, E - β thalassemia (0.6% each) and thalassemia major (0.4%).
This study provides a comprehensive database on the spectrum of haemoglobinopathies in the Armed Forces. It is suggested that detection of HbA2 should be carried out in all the high-risk groups with anaemia.
地中海贫血和其他结构性血红蛋白病是包括印度在内的世界某些地区普遍存在的主要遗传性疾病。本研究呈现了两年期间转诊的贫血患者中血红蛋白病的模式。
在两年期间共研究了1032例贫血患者以进行贫血调查。所有病例均进行了血液学指标、镰状试验以及血红蛋白电泳并对条带进行定量分析。
在1032例病例中,774例(75%)正常,258例(25%)血红蛋白模式异常。在258例异常病例中,136例(53%)为男性,122例(47%)为女性。在所有贫血病例中,370例(36%)为小细胞低色素性贫血,237例(23%)为大细胞性贫血,151例(15%)为双形性贫血,其余(26%)为正细胞正色素性贫血。82%的小细胞低色素性贫血患者血清铁降低且总铁结合力(TIBC)升高,而85%的患者血清铁蛋白水平降低。普遍存在的血红蛋白病谱为β地中海贫血特征(17%),其次是镰状细胞特征(2.3%)。其他血红蛋白病按频率由高到低依次为镰状细胞病(1.7%)、Hb D特征(1%)、Hb E特征(0.8%)、镰状细胞 - β地中海贫血、Hb E病、E - β地中海贫血(各0.6%)以及重型地中海贫血(0.4%)。
本研究提供了关于武装部队中血红蛋白病谱的综合数据库。建议对所有贫血高危人群进行HbA2检测。