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粤西阳江地区需输血治疗的地中海贫血患者的基因型分布及临床特征

Genotype Distribution and Clinical Characteristics of Thalassemia Patients Needing Transfusion in Yangjiang, Western Guangdong.

作者信息

Chen Zhi-Xiao, Liu Rong-Huo, Huang Jian-Cheng, Mo Jia-Min, Zeng Yan-Qing, Huang Yu-Chan, Yang Li-Ye

机构信息

Department of Transfusion, People's Hospital of Yangjiang, Yangjiang, PR China.

Precision Medical Lab Center, People's Hospital of Yangjiang, Yangjiang, PR China.

出版信息

Transfus Med Hemother. 2024 Aug 28;52(3):202-210. doi: 10.1159/000540518. eCollection 2025 Jun.

Abstract

OBJECTIVES

This study aimed to evaluate the distribution of genotypes and iron metabolism imbalance in transfusion-dependent thalassemia patients.

METHODS

Genotype analysis was conducted on 84 thalassemia patients requiring transfusion, and retrospective analysis of iron overload was performed on 48 transfusion-dependent patients.

RESULTS

Among the 84 thalassemia cases requiring transfusion, six mutations of α-thalassemia were identified, including --, α, -α, -α, α, and α. Nine mutations of β-thalassemia were also found, with CD41-42 being the most common. Of the 48 transfusion-dependent patients, 40 (83.3%) had iron overload with serum ferritin (SF) levels above 1,000 ng/mL. The recent SF level was lower than 3 years ago, but the overall ferritin level remains elevated.

CONCLUSIONS

β-thalassemia was the predominant type among transfusion-dependent thalassemia patients, with CD41-42/-28, CD41-42/IVS-II-654, and CD17/IVS-II-654 being the most common genotypes. Proper blood transfusion and iron chelation therapy are essential for managing transfusion-dependent thalassemia. While some patients show a reduction in SF levels after 3 years of treatment, there are still individuals who exhibit elevated levels necessitating ongoing management.

摘要

目的

本研究旨在评估输血依赖型地中海贫血患者的基因型分布及铁代谢失衡情况。

方法

对84例需要输血的地中海贫血患者进行基因型分析,并对48例输血依赖型患者进行铁过载回顾性分析。

结果

在84例需要输血的地中海贫血病例中,鉴定出6种α地中海贫血突变,包括--、α、-α、-α、α和α。还发现9种β地中海贫血突变,其中CD41-42最为常见。在48例输血依赖型患者中,40例(83.3%)存在铁过载,血清铁蛋白(SF)水平高于1000 ng/mL。近期SF水平低于3年前,但总体铁蛋白水平仍居高不下。

结论

β地中海贫血是输血依赖型地中海贫血患者中的主要类型,CD41-42/-28、CD41-42/IVS-II-654和CD17/IVS-II-654是最常见的基因型。适当的输血和铁螯合治疗对于管理输血依赖型地中海贫血至关重要。虽然一些患者在治疗3年后SF水平有所下降,但仍有个体水平升高,需要持续管理。

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