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[葡萄糖-6-磷酸脱氢酶缺乏症的临床特征及实验室数据分析]

[Clinical Features and Laboratory Data Analysis of Glucose-6- Phosphate Dehydrogenase Deficiency].

作者信息

Wang Zhao, Liu Si-Han, Bo Li-Jin, Zheng Yi-Zhou, Shi Jun, Xu Yan, Sun Xue, Zhao Yu-Ping

机构信息

Institute of Hematology and Blood Disease Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College,Tianjin,300020,China.

Institute of Hematology and Blood Disease Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College,Tianjin,300020,China.E-mail:

出版信息

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2018 Oct;26(5):1437-1441. doi: 10.7534/j.issn.1009-2137.2018.05.030.

DOI:10.7534/j.issn.1009-2137.2018.05.030
PMID:30295264
Abstract

OBJECTIVE

To explore clinical features and laboratory data of glucose-6-phosphate dehydrogenase(G6PD)deficiency and to investigate the relationship between them.

METHODS

Clinical data of 43 patients with G6PD deficiency was analyzed, the statistical method was applied to investigate the relationship between clinical features and laboratory data.

RESULTS

Among 43 patients,neonatal jaundice occurred as the first symptom in 10 cases,while acute hemolytic anemia occurred as the first symptom in 23 cases. The major clinical symptoms of G6PD deficiency included icteric skin and/or sclera,dark urine,fever,gastrointestinal symptoms,fatigue and lethargy. Symptoms of 26 patients were caused by obvious inducement,including fava beans(61.5%),infection(34.6%)and miocardial infarction(3.8%). All of 43 patients showed decreased G6PD activity,while the level of their indirect serum bilirubin(IBIL)was positively correlated with reticulocyte percentage(Ret%,r=0.5881,P=0.013) and mean corpuscular volume(MCV,r=0.6854,P=0.0024). Patients with neonatal jaundice as the first symptom,showed higher level of Ret%(P<0.01)and MCV(P<0.001)and low RBC count(P<0.01)and low Hb level(P<0.01). as compard with patients with acute hemolytic anemia as first symptome.

CONCLUSION

Neonatal jaundice and acute hemolytic anemia are common clinical features of G6PD deficiency. Laboratory results of IBIL,Ret% and MCV have auxiliary value to evaluate the severity of hemolysis induced by G6PD deficiency. Patients with neonatal jaundice as their first symptom show more severe hemolysis than those only suffered from acute hemolytic anemia.

摘要

目的

探讨葡萄糖-6-磷酸脱氢酶(G6PD)缺乏症的临床特征和实验室数据,并研究它们之间的关系。

方法

分析43例G6PD缺乏症患者的临床资料,应用统计学方法研究临床特征与实验室数据之间的关系。

结果

43例患者中,10例以新生儿黄疸为首发症状,23例以急性溶血性贫血为首发症状。G6PD缺乏症的主要临床症状包括皮肤和/或巩膜黄染、深色尿、发热、胃肠道症状、乏力和嗜睡。26例患者的症状由明显诱因引起,包括蚕豆(61.5%)、感染(34.6%)和心肌梗死(3.8%)。43例患者G6PD活性均降低,血清间接胆红素(IBIL)水平与网织红细胞百分比(Ret%,r=0.5881,P=0.013)和平均红细胞体积(MCV,r=0.6854,P=0.0024)呈正相关。以新生儿黄疸为首发症状的患者,与以急性溶血性贫血为首发症状的患者相比,Ret%水平更高(P<0.01)、MCV更高(P<0.001),红细胞计数更低(P<0.01),血红蛋白水平更低(P<0.01)。

结论

新生儿黄疸和急性溶血性贫血是G6PD缺乏症常见的临床特征。IBIL、Ret%和MCV的实验室结果对评估G6PD缺乏症所致溶血的严重程度有辅助价值。以新生儿黄疸为首发症状的患者溶血比仅患急性溶血性贫血的患者更严重。

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