Kim K Y, Yang C H, Cho M J, Lee M
Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.
J Korean Med Sci. 1988 Sep;3(3):107-15. doi: 10.3346/jkms.1988.3.3.107.
A Total of 498 cases of hemophilia which were reported by sixteen medical centers in Korea were reviewed and analyzed. Hemophilia A comprised 425 cases (85.3%) and the remaining 73 cases (14.7%) were hemophilia B. One case was female and all other cases were male. There were known hemophilia patients in the family in 43.0% of cases and the involved members were brothers, maternal cousins, maternal uncles, and maternal grandfathers in descending order of frequency. The major symptoms of the patients were hemorrhagic, such as easy bruising and hemarthrosis followed by prolonged bleeding after trauma and soft tissue hematoma. The incidence of hemarthrosis increased significantly with age. The pediatric age group below the age of 15 consisted of 67.1% of the cases. According to the age at diagnosis, half (54.2%) of the severe cases were diagnosed before the age of 1 year. APTT was prolonged over 40 seconds in all cases and 291 cases showed severe prolongation over 80 seconds. Of 498 cases 273 cases (54.8%) belonged to the severe form (factor VII or IX level, less then 1%), whereas 182 cases (36.5%) and 43 cases (8.7%) belonged to the moderate (factor VIII or IX, 2-5%) and mild form (factor VIII or IX, 6-25%), respectively, Chronic arthropathy was present in 236 cases (49.6%), and the incidence increased significantly with age. The management of chronic arthropathy most commonly employed was rehabilitation in 25.4% of cases, but in 50.8% no management was given at all. The involved joints in descending order of frequency were knees, elbows and ankles. The complications were intracranial hemorrhage, Gl bleeding and nerve palsy in 48, 24, and 13 cases, respectively.
对韩国16个医疗中心报告的498例血友病病例进行了回顾和分析。甲型血友病425例(85.3%),其余73例(14.7%)为乙型血友病。1例为女性,其余均为男性。43.0%的病例家族中有已知血友病患者,受累成员依次为兄弟、母系表亲、母系舅舅和外祖父。患者的主要症状为出血,如易瘀伤和关节积血,其次为创伤后出血时间延长和软组织血肿。关节积血的发生率随年龄显著增加。15岁以下的儿童年龄组占病例的67.1%。根据诊断时的年龄,一半(54.2%)的重症病例在1岁前被诊断。所有病例的活化部分凝血活酶时间(APTT)均延长超过40秒,291例显示严重延长超过80秒。498例中,273例(54.8%)属于重型(因子VIII或IX水平低于1%),而182例(36.5%)和43例(8.7%)分别属于中型(因子VIII或IX,2-5%)和轻型(因子VIII或IX,6-25%)。236例(49.6%)存在慢性关节病,其发生率随年龄显著增加。慢性关节病最常用的治疗方法是康复治疗,占病例的25.4%,但50.8%的病例根本未进行治疗。受累关节按频率递减依次为膝关节、肘关节和踝关节。并发症分别为颅内出血48例、消化道出血24例和神经麻痹13例。