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重庆医科大学附属儿童医院临床分子医学检测中心、国家儿童健康与疾病临床医学研究中心、 儿童发育疾病研究教育部重点实验室、儿科学重庆市重点实验室,重庆 400014
王 明,Email:cmc_wm@163.com,研究方向:遗传代谢病。
邹 琳,Email: zoulin74@126.com。
收稿:2023-03-07,
修回:2023-04-03,
录用:2023-05-05,
纸质出版:2023-06-28
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王明,张大勇,邹琳.重庆地区28 287例疑似地中海贫血儿童基因检测分析[J].重庆医科大学学报,2023,48(6):621-627.
Wang Ming,Zhang Dayong,Zou Lin.Genetic testing of children with suspected thalassemia in Chongqing area of China: an analysis of 28 287 cases[J].Journal of Chongqing Medical University,2023,48(6):621-627.
王明,张大勇,邹琳.重庆地区28 287例疑似地中海贫血儿童基因检测分析[J].重庆医科大学学报,2023,48(6):621-627. DOI: 10.13406/j.cnki.cyxb.003263.
Wang Ming,Zhang Dayong,Zou Lin.Genetic testing of children with suspected thalassemia in Chongqing area of China: an analysis of 28 287 cases[J].Journal of Chongqing Medical University,2023,48(6):621-627. DOI: 10.13406/j.cnki.cyxb.003263.
目的
2
探讨重庆地区儿童地中海贫血基因检测阳性情况、基因型及分布特征。
方法
2
对2011年1月至2022年12月重庆医科大学附属儿童医院就诊的28 287例经血液学筛查疑似地中海贫血儿童进行常见α和β地中海贫血基因突变位点检测,分析检出率和地中海贫血携带者检出构成比的变化趋势及基因型分布情况。
结果
2
在28 287例疑似地中海贫血儿童中,共检测出15 249例地中海贫血患者,阳性率为53.91%。α、β、αβ地中海贫血阳性率分别为22.41%(6 340例)、30.43%(8 609例)和1.06%(301例),中重型地贫阳性率为2.47%(698例)。2011年至2022年间随年龄增加各组α地中海贫血携带者检出构成比的线性回归
k
值分别为-0.002、0.004、0.006、0.010、0.012,而β地中海贫血分别为0.011、0.004、0.002、-0.001。共检出21种α地中海贫血基因型,其中α地中海贫血主要基因型为--SEA/αα,占比69.58%。共检测出46种β地中海贫血基因型,其中β地中海贫血主要基因型为CD17/βN、CD41-42/βN及IVS-II-654/βN,占比分别为31.75%、27.92%、25.21%,一共为84.88%。
结论
2
重庆地区儿童地中海贫血常见基因突变位点检测阳性率较高,中重型比例也较高。2011年至2022年间α地中海贫血携带者随年龄段增大检出率升高,而β地中海贫血降低,表明部分β地中海贫血患者基因诊断时间较晚。重庆地区儿童地中海贫血基因型集中在--SEA/αα、CD17/βN、CD41-42/βN及IVS-II-654/βN,与重庆地区成人一致,与广东、广西等地贫高发区有差异。这些结果对于本地区地中海贫血的干预和预防具有重要意义。
Objective
2
To investigate the positive rate of thalassemia genes,genotypes,and distribution characteristics in children in Chongqing area of China.
Methods
2
Common α- and β-thalassemia gene mutation sites were detected for 28 287 children with suspected thalassemia who underwent hematological screening at Children’s Hospital of Chongqing Medical University from January 2011 to December 2022,and related analyses were performed to investigate the changing trends of detection rate and the composition ratio of thalassemia carriers,as well as genotype distribution.
Results
2
Among the 28 287 children with suspected thalassemia,there were 15 249 children with thalassemia,with a positive rate of 53.91%. The positive rates of α-,β-,and αβ-thalassemia were 22.41%(6 340 cases),30.43%(8 609 cases),and 1.06%(301 cases),respectively,and the positive rate of moderate-to-severe thalassemia was 2.47%(698 cases). From 2011 to 2022,the linear regression
k
-values of the composition ratio of α-thalassemia carriers in each age group were -0.002,0.004,0.006,0.010,and 0.012,respectively,while those for β-thalassemia were 0.011,0.004,0.002,and -0.001,respectively. A total of 21 α-thalassemia genotypes were detected,among which --SEA/αα was the main genotype accounting for 69.58%. A total of 46 β-thalassemia genotypes were detected,with the main genotypes of CD17/βN,CD41-42/βN,and IVS-II-654/βN,accounting for 31.75%,27.92%,and 25.21%,respectively,and 84.88% in total.
Conclusion
2
There is a relatively high positive rate of common thalassemia gene mutation sites in children in Chongqing area,as well as a relatively high proportion of children with moderate-to-severe thalassemia. From 2011 to 2022,the detection rate of α-thalassemia carriers increases with age,while that of β-thalassemia decreased with age,indicating that some β-thalassemia patients receive genetic diagnosis at an older age. In Chongqing area,the main thalassemia genotypes are --SEA/αα,CD17/βN,CD41-42/βN,and IVS-II-654/βN in children,which are consistent with those in adults,but are different from those in the areas with a high incidence rate of thalassemia,such as Guangdong and Guangxi provinces. These results have significant implications for the intervention and prevention of thalassemia in Chongqing area.
徐湘民 . 地中海贫血预防控制操作指南 [M ] . 北京 : 人民军医出版社 , 2011 .
Xu XM . Guidelines for Thalassemia prevention and control programme [M ] . Beijing : People's Military Medical Press , 2011 .
Piel FB , Weatherall DJ . The α-thalassemias [J ] . N Engl J Med , 2014 , 371 ( 20 ): 1908 - 1916 .
于 洁 , 宪 莹 , 姚秀云 , 等 . 重庆市学龄前儿童α地中海贫血的分子流行病学研究 [J ] . 中华血液学杂志 , 2014 , 35 ( 5 ): 419 - 423 .
Yu J , Xian Y , Yao XY , et al . Prevalence and molecular analysis of α-thalassemia in preschool children in Chongqing city [J ] . Chin J Hematol , 2014 , 35 ( 5 ): 419 - 423 .
姚秀云 , 张渝美 , 秦蓁子 , 等 . 重庆市汉族儿童β-地中海贫血的分子流行病学研究 [J ] . 中华儿科杂志 , 2013 , 51 ( 7 ): 518 - 522 .
Yao XY , Zhang YM , Qin ZZ , et al . Prevalence and molecular analysis of β-thalassemia in children of Han ethnicity in Chongqing city [J ] . Chin J Pediatr , 2013 , 51 ( 7 ): 518 - 522 .
重型β地中海贫血的诊断和治疗指南(2017年版) [J ] . 中华儿科杂志 , 2018 , 56 ( 10 ): 724 - 729 .
Guidelines for diagnosis and treatment of β-thalassemia major ( 2017 ) [J ] . Chin J Pediatr, 2018 , 56 ( 10 ): 724 - 729 .
廖燕霞 , 黄烁丹 . 新生儿地中海贫血筛查与早期干预效果分析 [J ] . 黑龙江医学 , 2016 , 40 ( 4 ): 380 - 381 .
Liao YX , Huang SD . Analysis of neonatal thalassemia screening and early intervention effect [J ] . Heilongjiang Med J , 2016 , 40 ( 4 ): 380 - 381 .
王燕燕 , 李晓辉 , 徐西华 . 地中海贫血诊治进展与我国现状 [J ] . 中国实用儿科杂志 , 2013 , 28 ( 6 ): 473 - 476 .
Wang YY , Li XH , Xu XH . Progress in diagnosis and treatment of thalassemia and current situation in China [J ] . Chin J Pract Pediatr , 2013 , 28 ( 6 ): 473 - 476 .
Li CK . New trend in the epidemiology of thalassaemia [J ] . Best Pract Res Clin Obstet Gynaecol , 2017 , 39 : 16 - 26 .
Modell B , Darlison M . Global epidemiology of haemoglobin disorders and derived service indicators [J ] . Bull World Health Organ , 2008 , 86 ( 6 ): 480 - 487 .
Giardine B , Borg J , Viennas E , et al . Updates of the HbVar database of human hemoglobin variants and thalassemia mutations [J ] . Nucleic Acids Res , 2014 , 42 ( D1 ): D1063 - D1069 .
杨 阳 , 张 杰 . 中国南方地区地中海贫血研究进展 [J ] . 中国实验血液学杂志 , 2017 , 25 ( 1 ): 276 - 280 .
Yang Y , Zhang J . Research progress on thalassemia in southern China—review [J ] . J Exp Hematol , 2017 , 25 ( 1 ): 276 - 280 .
Lai KT , Huang GF , Su L , et al . The prevalence of thalassemia in mainland China:evidence from epidemiological surveys [J ] . Sci Rep , 2017 , 7 ( 1 ): 920 .
王兴斌 , 黄 轶 , 熊 娟 , 等 . 重庆地区1 406例儿童地中海贫血基因突变类型分析 [C ] // 中华医学会第十五次全国儿科学术大会论文汇编(上册) . 成都 , 2010 : 296 - 297 .
Wang XB , Huang Y , Xiong J , et al . Analysis of 1 406 cases of thalassemia gene mutation types in children in Chongqing [C ] // Compilation of papers from the 15th National Pediatric Academic Congress of the Chinese Medical Association(previous volume) . Chengdu , 2010 : 296 - 297 .
李东明 , 何 升 . 30 417例儿童地中海贫血基因类型分析 [J ] . 中国当代儿科杂志 , 2021 , 23 ( 8 ): 841 - 847 .
Li DM , He S . Genotypes of thalassemia in children:an analysis of 30 417 cases [J ] . Chin J Contemp Pediatr , 2021 , 23 ( 8 ): 841 - 847 .
林业辉 , 范 联 , 张 章 , 等 . 471例儿童α地中海贫血缺失型基因谱分析 [J ] . 中国当代儿科杂志 , 2012 , 14 ( 4 ): 264 - 266 .
Lin YH , Fan L , Zhang Z , et al . Spectrum of gene deletion in 471 children with α-thalassemia [J ] . Chin J Contemp Pediatr , 2012 , 14 ( 4 ): 264 - 266 .
蔡文倩 , 胡晞江 , 熊 乾 , 等 . 中国武汉地区新生儿α-地中海贫血基因型分析 [J ] . 中国实验血液学杂志 , 2018 , 26 ( 1 ): 219 - 222 .
Cai WQ , Hu XJ , Xiong Q , et al . Prevalence and genotype analysis of newborn α-thalassemia in Wuhan area of China [J ] . J Exp Hematol , 2018 , 26 ( 1 ): 219 - 222 .
杨 嫄 , 朱丽丹 , 张 颖 , 等 . 重庆地区108 140例疑似贫血患者地中海贫血筛查及检出基因型分析 [J ] . 第三军医大学学报 , 2020 , 42 ( 17 ): 1750 - 1756 .
Yang Y , Zhu LD , Zhang Y , et al . Screening results and analysis on genotype of thalassemia in 108 140 anemia patients in Chongqing [J ] . J Third Mil Med Univ , 2020 , 42 ( 17 ): 1750 - 1756 .
李婉玲 , 唐 盈 , 曾华松 , 等 . 广州地区6 172例β-地中海贫血疑似儿童基因分析 [J ] . 广东医学 , 2018 , 39 ( 14 ): 2190 - 2192 .
Li WL , Tang Y , Zeng HS , et al . Genetic analysis of 6 172 suspected children with β-thalassemia in Guangzhou [J ] . Guangdong Med J , 2018 , 39 ( 14 ): 2190 - 2192 .
杜 伟 , 欧阳小峰 , 甘承文 , 等 . 重庆地区8 024例地中海贫血筛查结果及地贫基因型分析 [J ] . 重庆医科大学学报 , 2014 , 39 ( 5 ): 694 - 697 .
Du W , Ouyang XF , Gan CW , et al . Screening results and genetic diagnosis of thalassemia in 8 024 cases in Chongqing region [J ] . J Chongqing Med Univ , 2014 , 39 ( 5 ): 694 - 697 .
李思阅 , 李秋红 , 易四维 , 等 . 重庆地区育龄人群地中海贫血不同基因型血液学特征的分析 [J ] . 中国实验血液学杂志 , 2022 , 30 ( 1 ): 211 - 216 .
Li SY , Li QH , Yi SW , et al . Hematological characteristics of different genotypes of thalassemia among reproductive population in Chongqing [J ] . J Exp Hematol , 2022 , 30 ( 1 ): 211 - 216 .
容永忠 , 赖兆新 , 李 斌 , 等 . 广州海珠区地中海贫血基因诊断结果分析与研究 [J ] . 中国优生与遗传杂志 , 2012 , 20 ( 1 ): 23 - 24 .
Rong YZ , Lai ZX , Li B , et al . Analysis of thalassemia screening and gene diagnosis in the populations at reproductive age [J ] . Chin J Birth Health Hered , 2012 , 20 ( 1 ): 23 - 24 .
He S , Qin Q , Yi S , et al . Prevalence and genetic analysis of α- and β-thalassemia in Baise region,a multi-ethnic region in Southern China [J ] . Gene , 2017 , 619 : 71 - 75 .
李莉艳 , 李 强 , 宋兰林 , 等 . 69例αβ复合型地中海贫血的血液学和基因型研究 [J ] . 实用妇产科杂志 , 2011 , 27 ( 5 ): 378 - 382 .
Li LY , Li Q , Song LL , et al . The study of phenotypes and genotypes of 69 cases of αβ compound thalassemia [J ] . J Pract Obstet Gynecol , 2011 , 27 ( 5 ): 378 - 382 .
Serjeant GR , Serjeant BE , Mason KP , et al . β-thalassemia mutations in Jamaica :geographic variation in small communities [J ] . Hemoglobin , 2018 , 42 ( 5/6 ): 294 - 296 .
Li ZW , Chen DL , Shu Y , et al . A reliable and high throughput HPLC-HRMS method for the rapid screening of β-thalassemia and hemoglobinopathy in dried blood spots [J ] . Clin Chem Lab Med , 2023 , 61 ( 6 ): 1075 - 1083 .
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