Akinlosotu Morenike Agnes, Adegoke Samuel Ademola, Oseni Saheed Babajide, Adeodu Oluwagbemiga Oyewole
Department of Paediatrics, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria.
Department of Paediatrics and Child Health, Obafemi Awolowo University, Ile-Ife, Nigeria.
Niger Postgrad Med J. 2017 Oct-Dec;24(4):195-200. doi: 10.4103/npmj.npmj_107_17.
Foetal haemoglobin (HbF, α2γ2) retards polymerisation of haemoglobin (Hb) in sickle cell anaemia (SCA). In Nigeria, studies on the levels of HbF and its relationship with haematological indices are scanty. This study evaluated HbF concentrations of children with SCA from Southwestern Nigeria and correlated the levels with various haematological indices.
HbF levels were quantified by high-performance liquid chromatography and haematological parameters determined with automated haemoanalyser. The relationship between steady-state HbF levels and blood parameters were assessed by statistical analyses.
The mean HbF of the 91 children with SCA (9.6% ± 5.9%) was significantly higher than 0.5 ± 0.7% for the 91 age- and sex-matched controls, P < 0.001. About two-third of children with SCA, sixty (65.9%) had low HbF levels (HbF of < 10%) whereas about one-third, 31 (34.1%) had high HbF level (HbF of ≥ 10%). The mean Hb concentration, haematocrit (Hct) and total red blood cell count were significantly lower amongst children with SCA, whereas the total white blood cell (WBC) counts, neutrophils, monocyte and lymphocyte percent, platelet counts, mean corpuscular Hb (MCH) and MCH concentration were significantly higher. HbF had a positive but weak correlation with Hct (r = 0.24, P = 0.014), Hb concentration (r = 0.21, P = 0.047) and red cell distribution width (r = 0.25, P = 0.015) and an inverse correlation with WBC count (r = -0.23, P = 0.038).
Children with SCA had higher levels of HbF than matched controls. HbF had an inverse correlation with the WBC count and direct relationship with Hct and Hb concentration. It is recommended that routine determination of HbF and its induction are essential to maintain optimal haematological state of patients with SCD.
胎儿血红蛋白（HbF，α2γ2）可延缓镰状细胞贫血（SCA）中血红蛋白（Hb）的聚合。在尼日利亚，关于HbF水平及其与血液学指标关系的研究较少。本研究评估了尼日利亚西南部SCA患儿的HbF浓度，并将其水平与各种血液学指标进行关联。
采用高效液相色谱法定量测定HbF水平，用自动血液分析仪测定血液学参数。通过统计分析评估稳态HbF水平与血液参数之间的关系。
91例SCA患儿的平均HbF水平为9.6%±5.9%，显著高于91例年龄和性别匹配的对照组（0.5±0.7%），P<0.001。约三分之二的SCA患儿，即60例（65.9%）HbF水平较低（HbF<10%），而约三分之一，即31例（34.1%）HbF水平较高（HbF≥10%）。SCA患儿的平均血红蛋白浓度、血细胞比容（Hct）和总红细胞计数显著较低，而总白细胞（WBC）计数、中性粒细胞、单核细胞和淋巴细胞百分比、血小板计数、平均红细胞血红蛋白含量（MCH）和MCH浓度显著较高。HbF与Hct（r=0.24，P=0.014）、血红蛋白浓度（r=0.21，P=0.047）和红细胞分布宽度（r=0.25，P=0.015）呈正相关但较弱，与WBC计数呈负相关（r=-0.23，P=0.038）。
SCA患儿的HbF水平高于匹配的对照组。HbF与WBC计数呈负相关，与Hct和血红蛋白浓度呈正相关。建议常规测定HbF及其诱导情况对于维持SCD患者的最佳血液学状态至关重要。
