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1、遗传性血色病临床及遗传学特点江军刘鑫钱伟叶进侯晓华江军,刘鑫,钱伟,叶进,侯晓华,华中科技大学同济医学院附属协和医院消化科湖北省武汉市430022江军,博士研究生,主治医师,主耍从事肝脏疾病的诊断、治疗方面的研究.通信作者:叶进,430022,湖北省武汉市解放大道号,华屮科技大学同济医学院附属协利医院消化科.Wjin8688@sina.com电话:027-85726381clinicalandgeneticcharacteristicsofhereditaryhemochromatosisJunJiang,XinLiu,WeiQian,JinYe,Xia
2、o-HuaHouJunJiangtXinLili,QianWei>JinYe,Xiao-HuaHou^DepartmentofGastroenterology,UnionHospitoLlongjiMedicalCollege,HuazhongUniversityofScienceandTechnology.Wuhan430022.HubeiProvinceChina.Correspondenceto:Dr.JinYe»DepartmentofGastroenterology,UnionHospitol,IbngjiMedicalCollege,Huaz
3、hongUniversityofScienceandTechnology.Wuhan430022.HubeiProvinceChina.Yejin8688@sina.comAbstractAEVI:lbstudytheclinicalandgeneticcharacteristisofhereditaiyhemochromatosis(HHC)andtoevaluatetheeffectofclinicalexaminationinHHCdiagnosis・METHODS:Theclinicalandlaboratoryfeaturesofpatient
4、soffamilialHHCweresummarized.PeripheralbloodsampleswerecollectedforSI、SF、TSexamination.MRIwasperformedonthesepatients.LiverbiopsywasperformedontheprobandandhissistersforHEandPerisPnissianbluestain.RESULTS:7patientsoffamilialHHC,includingtheproband,male,aged34,hisfather,his10-year
5、s-oldson,histwosistersandtwoelderbrothers,werediagnosis・Pigmententswasobservedinthreepatients・SFwereevaluatedinthreepatients,Hepatocellularirondepositionwasobservedintheprobandspccinicntsandhisyoungsiste匚TlieMRIfindingsshowedtheevidenceofirondepositionindifferentorgansofthesevenp
6、atients・CONCLUSION:HHCisararediseaseinchinaanddiagnosisisdifficult.PedigreescreeningandMRIareimportantfortheearlydiagnosis・KeyWords:HereditaryHemochromatosis;Diagnosis;Liver;MRI摘要目的:探讨遗传性血色病的临床及遗传学特点,评价铁工化指标、MRI、肝穿病理学检查在遗传性血色病诊断中的作用。方法:先证者因不明原因肝破化伴皮肤黏膜色索沉着来院确诊。除先证者外,该家系共有13人同怠接受调
7、査,均进行病史采集、体格检查。结介遗传学特点对怀疑有遗传性血色病者,进行临床、铁生化指标、胸腹部MRL病理纽织学等检查并进行详细临床评估。结果:共确诊7例,其中以先证者病情绘为严巫。这7例患者中3例出现皮肤黏膜色索沉着,1例肝硬化,未见糖尿病;7例患者血淸铁均正常,•其中3例血淸铁蛋白异常升高,2例血清铁蛋白低丁常;3例肝穿病理检查,其中2例肝铁过多沉积;而MRI显示每例患者至少有一个内脏器官的铁沉积,以肝脏铁沉积较为显著。结论:遗传性血色病患者■在我国狡少见,临床特点不明显,诊断因难,尤其是遗传性血色病早期患者。家系调查结合MRI检查在早期诊断中,显得
8、更为重要。关键词:遗传性血色病;诊断;肝脏;MRI0引言遗传性血色病(Hered