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[遗传性球形红细胞增多症中红细胞膜蛋白编码基因突变的临床表现]

[Clinical manifestations of erythrocyte membrane protein coding gene mutations in hereditary spherocytosis].

作者信息

Sun X J, Li H Y, Li D P, Liu Y Z, Zhang J Y, Yin Y K, Su M H, Pan H, Li Q L, Hu B, Liu H, Shi J

机构信息

Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China.

出版信息

Zhonghua Xue Ye Xue Za Zhi. 2018 Nov 14;39(11):912-916. doi: 10.3760/cma.j.issn.0253-2727.2018.11.008.

Abstract

To investigate the relationship between the erythrocyte membrane protein gene mutations and the clinical severity of hereditary spherocytosis (HS). Targeted sequencings were performed on 25 HS patients, correlation between HS mutations and patients' clinical characteristics were evaluated. A total of 25 HS patients were enrolled, including 13 males and 12 females with median age of 20 (4-55) years, including 9 compensatory hemolysis patients, 9 patients with mild anemia, 3 patients with moderate anemia and 4 patients with severe anemia. Of them, 18 patients (72%) harbored HS-related mutations, including ANK1 mutation in 6 cases, SLC4A1 mutation in 6 cases, SPTB mutation in 5 cases and 1 case with EPB41 mutation. Seven patients (28%) didn't carry common HS mutations. SPTB and SLC4A1 mutations mainly affected male patients. There was no significant difference between the age of diagnosis (=0.130) and HGB level (=0.585) in patients with HS mutation and those without mutation, however, the EMA binding fluorescence intensity (=0.015), AGLT50 (=0.032) and EOF minimal hemolytic concentration (=0.027) were significantly different in these two groups of HS patients. To screen erythrocyte membrane protein coding gene mutations could favor the diagnosis of HS, and patients without mutations have mild clinical phenotype.

摘要

探讨红细胞膜蛋白基因突变与遗传性球形红细胞增多症(HS)临床严重程度之间的关系。对25例HS患者进行靶向测序,评估HS突变与患者临床特征之间的相关性。共纳入25例HS患者,其中男性13例,女性12例,中位年龄为20(4 - 55)岁,包括9例代偿性溶血患者、9例轻度贫血患者、3例中度贫血患者和4例重度贫血患者。其中,18例(72%)携带HS相关突变,包括ANK1突变6例、SLC4A1突变6例、SPTB突变5例和EPB41突变1例。7例(28%)未携带常见的HS突变。SPTB和SLC4A1突变主要影响男性患者。有HS突变和无突变患者在诊断年龄(=0.130)和血红蛋白水平(=0.585)方面无显著差异,然而,这两组HS患者的伊红 - 甲基绿(EMA)结合荧光强度(=0.015)、酸化甘油溶血试验50%溶血时间(AGLT50,=0.032)和渗透脆性试验最小溶血浓度(EOF,=0.027)存在显著差异。筛查红细胞膜蛋白编码基因突变有助于HS的诊断,无突变的患者临床表型较轻。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/199a/7342345/734d2c218ba5/cjh-39-11-912-g001.jpg

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