海口地区人群地中海贫血基因型分析

目的了解海口地区人群地中海贫血基因型分布特点。方法采用Gap—PCR、PCR—RDB技术检测海口地贫人群3种缺失型、3种非缺失型α-地贫;17种β-地贫。结果海口地贫以α-地贫为主,α-地贫占总病例63．82％,三种缺失型地贫病例数相对均衡,α-地贫等位基因--^SEA／：-α^3.7／：-α^4.2／=1．49：1．40：1;β-地贫病例占总病例31．74％,检出9种基因型,排前5位的突变位点依次是CD41—42、IVS-Ⅱ-654、-28、CDl7、CD71—72,这5类病例占总β-地贫病例的93．55％;α-合并β-地贫病例占较大比重,达4．44％。结论海南地贫基因型有地域特点,应重视地贫防控。     

闽南地区罕见α地中海贫血基因型分析

目的：了解闽南地区罕见α地中海贫血基因突变类型,减少漏诊、误诊。方法对1879例血液学筛查为小细胞低色素的疑似地贫患者DNA样本,采用多聚酶链反应（ PCR）、反向斑点杂交（ RDB）和测序技术进行基因分析。结果检出α地贫802例（42．68％）,罕见地贫6例（0．32％）,包括2例（0．11％）香港型（HKαα）,2例（0．11％）泰国缺失型,1例（0．05％）-α-27．6缺失型和1例（0．05％）融合基因。结论初步阐明闽南地区独特的罕见α地贫基因型,为减少临床地贫的漏诊、误诊提供指导。     

一个β地中海贫血复合δβ地中海贫血家系的表型与基因型分析

目的：调查一种缺失型δβ地中海贫血（简称地贫）基因型与表型的关系,探索进行β地贫复合该缺失型突变高风险胎儿的快速产前诊断方法。方法：以表型和基因分型进行家系分析。表型分析采用红细胞指标和血红蛋白电泳分析;用跨越断裂点的三引物聚合酶链反应直接分析法检测δβ地贫缺失突变;用反向点杂交技术筛查β地贫基因突变;并对一例该型地贫高风险胎儿进行了产前基因诊断。结果：先证者（重症地贫）为一种缺失型δβ地贫与β地贫双重杂合子,其δβ地贫基因遗传自母方,在该家系3代9名成员中共检测到4例携带了这一基因,其表型和基因型结果相互吻合;β地贫基因（密码子41－42－CTTT移码突变）遗传自父方。对该家系的重症地贫高风险胎儿进行产前基因诊断的结果显示,胎儿的基因型完全正常。结论：在国内首次报告由缺失型δβ地贫基因与β地贫移码突变双重杂合导致的重平地贫高风险胎儿的产前诊断结果。采用的技术简便、快速,可用作同类事件的参考。     

64例地中海贫血常见与罕见基因型的表型分析

目的 对常见、罕见地贫基因型患者的表型分析,探讨不同基因型与表型间差异。方法 采用反向斑点杂交及gap-PCR技术检测来自南宁、柳州、百色等3地区64例患者地贫基因型并进行分组。收集患者治疗史、血液学与铁代谢的生化指标。采用Kruskal-Wallis检验或Welch one-way ANOVA检验分析患者表型特征。结果 检出58例常见基因型：30例β⁰/β⁰,28例HbH CS(α^CSα/--^SEA);6例罕见基因型：3例Hb CS纯合突变,3例HbH(-α^3.7/--^SEA)复合β⁰/β⁰。表型分析显示,β⁰/β⁰患者无输血生存时间最短,临床症状最重,HbH CS患者最轻,但临床表型异质性很大。Hb CS纯合突变与HbH CS患者相比,输血依赖程度与铁负荷明显重于后者。HbH复合β⁰/β⁰患者临床表型与β⁰     

云南省德宏地区产前诊断中地中海贫血基因分析

目的 探讨地中海贫血高发区云南德宏地区孕妇地贫基因分布情况,为地贫高发地区的疾病防控策略制定和遗传咨询提供参考依据.方法 采用液相芯片技术对德宏州人民医院的8928例孕妇进行地贫基因筛查,并根据筛查结果进行产前诊断,通过羊膜穿刺术对104例孕妇进行羊水检测以及遗传咨询.结果 8928例孕妇样本中检出2443例(27.3...     

梧州地区育龄人群地中海贫血基因型分布状况调查

目的调查梧州地区育龄人群地中海贫血的基因型分布状况,制定相应的地贫筛查策略。方法355名受检者均首先同时进行血液学表型分析及gap-PCR检测3种常见的缺失型α-地贫基因,血红蛋白电泳发现HbA2≥3.5%和/或HbF≥2.0%者,再采用反向点杂交法进行β-地贫基因检测。结果355名受检者中发现α-地贫携带者121例,占34.1%,--SEA、-α3.7、-α4.2这3种等位基因的构成比分别为78.1%、16.4%、5.5%。发现β-地贫杂合子74例,占20.8%,共检出8种β-地贫突变基因,最常见的5种基因-CD41-42、-28、IVS-II-654、CD17、CD71-72占所有突变基因的90.6%;检出β-地贫复合α-地贫双重杂合子共13例,占β-地贫携带者的17.6%。结论梧州地区为地中海贫血高发区,β-地贫杂合子复合α-地贫的发生率亦较高。应将gap-PCR作为临床上地贫筛查的一线技术,以有效检出静止型α-地贫,并减少β-地贫复合α-地贫双重杂合子漏检的可能,为遗传咨询和产前诊断提供更为准确可靠的信息。     

南宁地区中间型地中海贫血基因型与表现型分析

目的系统分析南宁地区中间型地中海贫血的基因型特征,通过临床回顾性研究表型和基因型的关系。方法应用琼脂糖凝胶电泳反向点杂交和Gap-PCR技术对检测167例样本的基因型和表型并进行分析。结果在167例样本中检测出130例为中间型α-地中海贫血。37例是中间型β-地中海贫血。其中包括了11例双重杂合子和26例具有表型的杂合子。结论中间型地中海贫血的分子遗传学机制有高度的异质性,其在南宁市的流行分布为该地区的遗传咨询和产前诊断提供依据。     

惠州地区α-地中海贫血基因型与红细胞参数的相关性

目的:研究惠州地区α-地中海贫血（α-地贫）患者基因型及其红细胞（RBC）参数变化,为临床α-地贫基因型的预测提供初步证据。 方法:将已确定的α-地贫基因类型的90例患者随机分为3组,其中α-地贫静止型患者30例、α-地贫标准型患者28例、α-地贫HbH型患者32例,同时选择 30例健康人作为对照组,分别检测各组对应的RBC参数指标,包括红细胞（RBC）计数、血红蛋白（HGB）、平均红细胞容积（MCV）、平均红细胞血红蛋白量（MCH）、红细胞体积分布宽度（RDW）。 结果:不同基因型的α-地贫患者均表现出不同程度的小红细胞低色素症状;与对照组相比,3种基因型的HGB、MCV、MCH均明显降低,且与贫血程度呈负相关,具有统计学意义（P<0.05）;同对照组相比,3种基因型的RDW明显升高,与贫血程度呈正相关,且有统计学意义（P<0.05）;随α-地贫患者由静止型向HbH型变化,其相应的RBC参数指标也呈现明显差异（P<0.05）。 结论:RBC相关参数具备成为α-地贫基因类型预测手段的潜力,值得进一步进行大样本和多中心研究。     

地中海贫血的产前诊断分析

目的对本院基因诊断双方都是α地中海贫血基因携带者或双方都是β地中海贫血基因携带者的夫妇进行产前基因诊断,以杜绝中、重型α和β地中海贫血患儿的出生。方法在孕16～35周时对有生中、重型地贫儿风险的孕妇行羊膜腔穿刺术获得胎儿细胞,采用gap-PCR法检测胎儿三种缺失型α地中海贫血(-α3.7、-α4.2、--SEA)基因型。采用反向点杂交技术(RDB法)检测胎儿三种α基因点突变型(αQSα、αCSα、αWSα)及中国常见17种β基因点突变(41-42、654、-28、71-72、17、βE、31、27/28、IVS-1-1、43、-32、-29、-30、14-15、CAP、Int、IVS-1-5位点正常序列及突变)。结果 275对高危夫妇胎儿中,检测出巴氏水肿胎儿(Hb Bart′s)(基因型:--SEA/--SEA)30例,血红蛋白HbH病(基因型:--SEA/-α3.7,--SEA/-α4.2,--SEA/αCSα,--SEA/αWSα)25例,α地中海贫血携带者(基因型:--SEA/αα、-α3.7/αα、-α4.2/αα、αCSα/αα、αQSα/αα、αWSα/αα)74例,正常(基因型:αα/αα)39例。β地中海贫血纯合子11例,β地中海贫血双重杂合子14例,β地中海贫血携带者51例,未检测出中国常见17种β突变的31例。结论地中海贫血的产前诊断技术可以有效的减少中、重度地贫儿的出生。     

53例地中海贫血产前基因诊断与临床分析

目的回顾性分析地中海贫血基因产前诊断病例,了解重型地贫胎儿的基因型状况。方法通过介入性产前诊断方法获取胎儿DNA,应用聚合酶链反应（PCR）方法进行地贫产前基因诊断。结果 53对夫妇的胎儿分别检出HbBart＇s胎儿水肿综合征10例,HbH病1例,α地贫-1杂合子16例,α地贫-2缺失型1例,静止型α地贫5例,β地贫中间型（BEM）2例,重型β地贫6例,轻型β地贫12例,其中α、β复合型轻型地贫4例。结论 PCR产前基因诊断法能有效地检出各种常见地贫杂合子和纯合子。     

深圳市盐田区地中海贫血分子流行病学调查

目的以盐田区户籍居民的样本为例调查深圳市地中海贫血基因突变的携带率、分布情况和基因突变类型。方法采用SysmexSE．9000全自动血液分析仪对盐田区35岁以下户籍居民（4652人）进行血细胞分析．同时通过Gap．PCR、DNA测序法对其进行地中海贫血基因突变检测。结果4652人中,地贫基因携带者共497人,总携带率为10．68％。其中α-地贫基因携带者377人（8．10％）,β-地贫基因携带者108人（2．32％）,α-地贫复合β-地贫12人（0．26％）。在α-地贫基因携带者中以东南亚型——SEA型居多（4．77％）。β-地贫基因携带者中以CD41．42所占人数最多（1．10％）。结论深圳盐田区户籍居民地贫基因携带率与广东省总体携带率基本一致。本研究对开展该地区的地贫遗传咨询、基因分析及产前诊断工作具有重要的参考价值。     

β-地中海贫血的基因诊断及产前基因诊断

目的减少β-地中海贫血重症患儿的出生.方法对106例经血液学筛查疑为β-地中海贫血的杂合子携带者行PCR-RDB法进行基因诊断及产前基因诊断.结果共筛出β-地中海贫血阳性患者52例;19例产前基因诊断中,确定正常胎儿9例,重症胎儿2例(纯合子1例,双重杂合子1例),重症β-地中海贫血胎儿诊断后采取引产术终止妊娠.结论PCR-RDB法进行基因诊断及产前基因诊断有效避免了重症患儿的出生,达到了优生的目的.     

Alpha thalassemia among sickle cell anaemia patients in Kampala,Uganda

Background

Sickle cell anaemia is prevalent in sub Saharan Africa. While α+-thalassaemia is known to modulate sickle cell anaemia, its magnitude and significance in Uganda have hitherto not been described.

Objectives

To determine the prevalence of α+thalassaemia among sickle cell anaemia patients in Mulago Hospital and to describe the clinical and laboratory findings in these patients.

Methods

A cross sectional study was carried out on patients with sickle cell anaemia in Kampala. Dried blood spots were used to analyze for the deletional α+ thalassaemia using multiplex polymerase chain reaction.

Results

Of the 142 patients with sickle cell anaemia, 110 (77.5%) had the αα+thalassaemia deletion. The gene frequency of (−α) was 0.425. Ninety one percent (100/110) of those with α+thalassaemia were heterozygous (αα/α-). Amongst the patients older than 60 months, 15 (83.3%) of those without αα+thalassaemia had significant hepatomegaly of greater than 4 cm compared to 36 (45.6%) of those with α+thalassaemia (p=0.003).

Conclusion

The gene frequency of (−α) of 0.425 noted in this study is higher than that reported from many places in Africa. Concurrent alpha thalassemia might be a protective trait against significant hepatomegaly in sickle cell anaemia patients more than 60 months of age at Mulago hospital.     

佛山市南海区2300例孕妇地中海贫血筛查结果及基因突变类型分析

目的 了解佛山市南海区孕妇地中海贫血筛查结果及基因突变类型,为预防地中海贫血患儿出生提供依据.方法 选取201 3年1月至201 8年12月于佛山市南海区第二人民医院行产前检查的孕妇2300例,采用全自动血细胞分析仪检测血常规,采用红细胞(RBC)脆性试验和血红蛋白(Hb)电泳试验进行地中海贫血初筛,对初筛阳性标本采用...     

粤北地区地中海贫血检出率及基因分型的调查分析

目的 了解粤北地区地中海贫血的发病情况及基因分型。方法 红细胞休克-管定量法对所有受检人进行地贫筛查，对地贫筛查阳性的标本进一步采用PCR法进行α地贫1基因检测，用PCR结合反向点杂交法(RDB)，进行β地贫的基因检测。结果 在1010例受检者中，地贫筛查阳性的有118例，占受检总人数的11．6％。地贫筛查阳性的所有标本均进行了α地贫1基因检测，诊断为α地贫1杂合子的有69例，占受检总数的6．83％，32例进行了β地贫基因检测，其中21例为β地贫杂合子，占受检总数的2．1％，其基因突变类型分别是：CD41—42(-TTCT)突变12例，IVS-2—654(C→T)突变2例，-28(A→G)突变2例，CD17(A→T)突变2例，71-72( A)突变2例，27—28( C)突变1例。结论 粤北地区地中海贫血发生率较高。做好婚前及产前地贫筛查及产前基因诊断等工作，对避免重型地贫患儿的出生，具有重要意义。     

Mutation analysis of Gaucher disease patients from Argentina: High prevalence of the RecNciI mutation

Gaucher disease (GD) is caused by a deficiency of β-glucocerebrosidase activity mainly due to mutations in the gene coding for the enzyme. More than 100 mutations have been identified to date and their frequencies have been established in several populations, including Ashkenazi Jews, among whom the disease is particularly prevalent. In order to study the molecular pathology of the disease in patients from Argentina, we conducted a systematic search for mutations in the glucocerebrosidase gene. Genomic DNA from 31 unrelated GD patients was screened for seven previously described mutations: N370S (1226A→G), L444P (1448T→C), D409H (1342G→C), R463C (1504C→T), 1263del55, RecNciI, and RecTL. This allowed the identification of 77.4% of the GD alleles: N370S and RecNciI were the most prevalent mutations found (46.8% and 21% respectively). Southern analysis demonstrated three distinct patterns for the RecNciI alleles. In order to identify the remaining alleles, the full coding region of the gene, all the splice sites, and part of the promoter region were analyzed by single-strand conformational polymorphism analysis (SSCP) after polymerase chain reaction amplification. This extensive screening allowed the identification of 13 different mutations, accounting for 93% of the total number of GD alleles. Three novel missense mutations, I161S (599T→G), G265D (911G→A), and F411I (1348T→A), were detected. Twelve polymorphic sites within the glucocerebrosidase gene are in complete linkage disequilibrium and define two major haplotypes, “−” and “+”. Mutation N370S was always associated with the “−” haplotype, as described in other populations. Interestingly, the RecNciI alleles with the same Southern-blot pattern were always associated with the same haplotype. Am. J. Med. Genet. 80:343–351, 1998. © 1998 Wiley-Liss, Inc.     

β‐thalassemia in the German population: Mediterranean,Asian and novel mutations

The β‐thalassemia mutations of 13 unrelated heterozygous Germans who remained unidentified in a previous study of 40 subjects were investigated at the DNA level. Two Mediterranean, one Asian and three novel mutations (CD6 ‐G, CDs 108 /112‐12nt, CDs 130/131 +GCCT) were identified. Altogether, in 30 of the 35 subjects (86%) in which a mutation in the β‐globin gene was identified, the mutation was of Mediterranean origin. The geographical distribution suggests recent migration from the Mediterranean region as cause of the high proportion of frequent Mediterranean β‐thalassemia mutations in the German population. Our results support the notion that the majority of β‐thalassemia genes in the western and central European population are of Mediterranean origin. © 1999 Wiley‐Liss, Inc.     

Clinical, hematological and genetic features of sickle-cell anemia and sickle cell-β thalassemia in a Brazilian population

Clinical, hematological and genetic studies were carried out on 40 patients with symptomatic sickle-cell disease, selected on the basis of a predominant HbS fraction and absence of other abnormal hemoglobin variants. Family studies showed they included 26 homo-zygotes for the sickle-cell gene (SS) and 14 double heterozygotes for both the sickle-cell and the β°-thalassemia genes (Sβ°-thalassemia). Comparison of the two groups revealed the more common occurrence of splenomegaly, lower MCV and MCH, and higher HbAa in Sβ°-thalassemia. Total hemoglobin was slightly lower in SS disease but the difference was not significant. Fetal hemoglobin (HbF) was moderately elevated to similar levels in both groups. These results suggest a high incidence of Sβ°thalassemia in certain Brazilian mixed populations and confirm the severity of the double heterozygous state. The distinction between the two disorders is often difficult, but can be made on the basis of the hematological data taken together with family studies.     

Current status of thalassemia in minority populations in Guangxi, China

Thalassemia is one of the most common monogenic disorders in the world. In order to develop a community-based prevention program, we screened 12,900 individuals for alpha- and beta-thalassemia in Baise City, Guangxi, China, with hematological methods and molecular assays. We found that the frequency of carriers in this area for alpha-thalassemia is 15%. Beta-thalassemia carriers comprise 4.8% of the populations. Five mutations account for 98% of alpha-thalassemia [--SEA 46.7%; -alpha/4.2, 23.9%; -alpha/3.7, 21.7%; hemoglobin (Hb) Constant Spring, 6.5%; Hb Quong Sze, 1.1%]. Seven mutations in the beta-globin gene account for 99% of the mutations [codon (CD) 41/42 (-TCTT) (39.4%), CD 17(A-->T) (32%), CD 71/72 (+A) (7.4%), -28 (A-->G) (5.8%), IVS-2-654 (C-->T) (5.8%), CD26 (Hb E) (4%), IVS-1 (G-->A) (3.7%), and CD 43(G-->T) (1.9%)]. Most individuals with alpha-thalassemia major die in the uterus or shortly after birth. Among 106 patients with beta-thalassemia major followed by our clinic, the majority died before 5 years of age. Knowledge surveys about thalassemia were conducted. Our results show a severe lack of knowledge about thalassemia in both medical professionals and in the general populations. This study shows that thalassemia is a very severe public health issue in minority populations in Baise City, China. Identification of the common mutations will allow us to design cost-effective molecular tests. There is an urgent need to educate the general population and the medical community for a successful community-based prevention program.