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[中国福建南平地区地中海贫血基因突变类型分析]

[Analysis of the Types of Thalassemia Gene Mutations in Nanping Area of Fujian, China].

作者信息

Chen Ming-Fa, Huang Min-Zhong, Lin Quan, Huang Jia, Chen Fang, Zhang Jia-Ying, Xue Fei

机构信息

Prenatal Diagnosis Center of Nanping Municipal Maternal and Child Health Hospital in Fujian Province, Nanping 353000, Fujian Province, China,E-mail:

Prenatal Diagnosis Center of Nanping Municipal Maternal and Child Health Hospital in Fujian Province, Nanping 353000, Fujian Province, China.

出版信息

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2020 Jun;28(3):918-926. doi: 10.19746/j.cnki.issn.1009-2137.2020.03.033.

Abstract

OBJECTIVE

To investigation the types and frequencies of thalassemia gene mutations in pregnant population in Nanping area of Fujian Province, so as to provide a basis for prevention and control of birth children with moderate and severe thalassaemia in this area.

METHODS

The genotyping of α and β thalassemia was performed using the gap-PCR (gap-PCR) technique combined with reverse dot blot (RDB). The genotyping test was performed by Gap-PCR for three rare deficient thalassemia. The cases with negative detection were further detected by Sanger sequencing method, so as to identify rare α or β thalassemia mutation.

RESULTS

1120 specimens were genotyped for thalassemia, out of them 547 thalassemia genes were determined. The detection rate was 48.8% (547/1120). 340 specimens were diagnosed as α thalassemia, and the detection rate was 30.6%, including 266 cases of --/αα, 44 cases of -α/αα, 12 cases of -α/αα, 8 cases of αα/αα,. 3 cases of Hb H disease ( 2 cases of --/-α, 1 case of --/-α), 2 cases of αα/αα, 2 cases of αα/αα, 1 case of -α/-α, and 1 case of -α/αα. Also, they contain 11 cases of rare α thalassemia, 8 kinds of rare types of α thalassemia mutations in combination, such as 4 cases of αα/αα, 1 case of αα/αα, 1 case of αα/αα, 1 case of αα/αα, 1 case of αα/αα, 1 case of αα/αα, 1 case of αα/αα, and 1 case of --/αα. Among them, 5 α mutation sites were first reported, namely αα, αα, αα, αα and αα; 2 α thalassemia mutation sites: αα and -- were detected again in the Chinese population, respectively. 188 specimens were diagnosed as β thalassemia with a detection rate of 16.8%. Among them, 68 cases of β/βN, 47 cases of β/βN, 20 cases of β/βN, 17 cases of β/βN, 7 cases of β/βN, 7 cases of βE/βN, 3 cases of β/βN and 2 cases of β/βN. And 17 cases were diagnosed as rare β thalassemia, 8 kinds of rare types were β thalassemia mutations in combination. There were 4 cases of β/βN, 3 cases of β/βN, 3 cases of β/βN, 2 cases of β/βN, 2 cases of β/βN, 1 case of β/βN, 1 case of β/βN, 1 case of β/βN. Among them, 3 β thalassemia mutation sites were reported for the first time, namely β, β and β; it was found that in the Chinese population as β, β, β, β, and β, respectively. 19 cases were diagnosed as αβ-complex thalassemia, out of which 15 types of thalassemia mutation combinations were detected. They contain 2 cases of rare αβ-complex thalassemia, which are αα/αα complex β/βN, αα in α1/αα complex β/βN.

CONCLUSION

The types of thalassemia gene mutations in Nanping area of Fujian province are genetically heterogeneous. The prevention and control strategies of thalassaemia in this area should be based on the prevention and treatment of common α thalassemia and β thalassaemia. And the attention should be paid to the types of rare and unknown gene mutations using screening and testing method.

摘要

目的

调查福建省南平地区孕妇人群地中海贫血基因突变类型及频率,为该地区预防和控制中重型地中海贫血患儿出生提供依据。

方法

采用缺口聚合酶链反应(gap-PCR)技术联合反向点杂交(RDB)进行α和β地中海贫血基因分型检测。采用Gap-PCR对3种罕见缺失型地中海贫血进行基因分型检测。对检测阴性的病例进一步采用Sanger测序法检测,以鉴定罕见的α或β地中海贫血突变。

结果

对1120份标本进行地中海贫血基因分型,共检测出547个地中海贫血基因,检出率为48.8%(547/1120)。确诊α地中海贫血340例,检出率为30.6%,其中--/αα 266例、-α/αα 44例、-α/αα 12例、αα/αα 8例。Hb H病3例(--/-α 2例、--/-α 1例),αα/αα 2例,αα/αα 2例,-α/-α 1例,-α/αα 1例。还包含11例罕见α地中海贫血,8种罕见类型的α地中海贫血突变组合,如αα/αα 4例、αα/αα 1例、αα/αα 1例、αα/αα 1例、αα/αα 1例、αα/αα 1例、αα/αα 1例、--/αα 1例。其中,5个α突变位点为首次报道,分别为αα、αα、αα、αα和αα;2个α地中海贫血突变位点:αα和--分别在中国人群中再次被检测到。确诊β地中海贫血188例,检出率为16.8%。其中β/βN 68例、β/βN 47例、β/βN 20例、β/βN 17例、β/βN 7例、βE/βN 7例、β/βN 3例、β/βN 2例。确诊罕见β地中海贫血17例,8种罕见类型为β地中海贫血突变组合。分别为β/βN 4例、β/βN 3例、β/βN 3例、β/βN 2例、β/βN 2例、β/βN 1例、β/βN 1例、β/βN 1例。其中,3个β地中海贫血突变位点为首次报道,分别为β、β和β;在中国人群中分别发现为β、β、β、β和β。确诊αβ复合型地中海贫血19例,共检测出15种地中海贫血突变组合类型。包含2例罕见αβ复合型地中海贫血,分别为αα/αα复合β/βN、α1/αα复合β/βN。

结论

福建省南平地区地中海贫血基因突变类型具有遗传异质性。该地区地中海贫血防控策略应以常见α地中海贫血和β地中海贫血的防治为基础,同时应采用筛查和检测手段关注罕见及未知基因突变类型。

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