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1、珠蛋白生成障碍性贫血HbCS-H病的筛查与诊断现状魏彩霞欧阳小峰杨雯刘丹王滔沙春芳昆明金域医学检验所摘要:目的对非缺失型Q珠蛋口生成障碍性贫血(后简称地贫)血红蛋口(lib)CS-II病表型及基因型的表现特点和防控现状进行分析,以加强产前筛查医务工作者对HbCS-H病的诊断水平和防控意识。方法采用全血细胞分析仪、SebiaCapillarys2型毛细管电泳仪检测地贫表型;采用跨越断裂点聚合酶链反应(GAP-PCR)和聚合酶链反应(PCR)反向点杂交技术(RDB)检测国内常见的3种缺失型a地贫(aa/--SEA、aa/a3.7、a
2、a/a4.2),3种常见a地贫点突变(aCS、aQS、aWS)和17种B地贫点突变基因。结果104361例地贫筛查者中,毛细管电泳出现CS条带的296例(0.28%),包括CS型、CS+H+Bart7s型、CS+H型、CS+HbE型、CS+异常Hb条带型等5种表现形式。其中,24例电泳出现CS+H+Bart7s型,2例出现、CS+H型异常条带,全部26例患者经基因确诊为IlbCS-Il病,基因型均为一SEA/aCSao选取30例电泳无CS条带者作为对照,均未能检测到CS基因。结论HbCS-H病患者所携带的SEA和CS基因分别来自
3、父母双方;单纯携带SEA或CS者,血液学表现为轻微界常或正常。毛细管电泳能有效分离出CS条带,提高对电泳筛查报告单的解读能力,正确应用基因确诊手段,发现有可能出生HbCS-H患儿的高危家庭并进入产前诊断,对防控IlbCS-Il患儿的岀生有重要意义。关键词:珠蛋白牛成障碍性贫血;血红蛋白CS-H病;筛查;诊断;基因突变;作者简介:魏彩霞,女,主任技师,主要从事血液学与遗传方面的研究。收稿日期:2017-04-29基金:云南省科技厅创新型试点企业资助项目(2069999)Currentstatusofscreeninganddiag
4、nosisofthalassemiaHbCS~HdiseaseWEICaixiaOUYANGXiaofengYANGWenLIUDanWANGTaoSHAChunfangKunmingKingmedMedicalLaboratoryInstitute;Abstract:ObjectiveToanalyzethemanifestationscharacteristicsandpreventionandcontrolstatusquoofphenotypeandgenotypeinnon-deletionalthalassemiah
5、emoglobin(Hb)CS-HdiseaseinordertoincreasethediagnosislevelofthemedicalstaffsconductingtheprenataiscreeningtoHbCS-Hdiseaseandstrengthenthepreventionandcontrolawarenessonthisdisease.MethodsThewholebloodcel1sanalyzerandSebiaCapillarystype2capillaryelectrophoresis(CE)app
6、aratuswereeippliedtodetectthalassemiaphenotype;GAP-PCRandPCRreversedot-blot(RDB)hybridizationtechniquewereusedtodetect3kindsofmostcommondeletionalalphathalassemia(aa/一一SEA,aa/a3.7,aa/a4.2),3kindsofcommonalphathalassemiapointmutations(aCS,aQS,aWS)and17kindsofbetathala
7、ssemiapointmutationsathome.ResultsAmong104361casesofthalassemiascreening,CEappearedtheCSbandsin296cases(0.28%),includingthetypeCS,CS+H+Bartzs,CS+H,CS+HbE,CS+abnormalHbbands.Amongthem,24casesofelectrophoresisappearedthetypeCS+H+Bartzsin1case,typeCS+Hin2cases,thepatien
8、tswithtypeCS+HwerediagnosedasIlbCSHldiseasebygenedetection,thegenotypewas--SEA/flCSfl.ThirtycasesofelectrophoresiswithoutCSbandwere