孟加拉国一家三级医院室外血液科患者的遗传性血红蛋白疾病类型

Nur mohammad Rakib, Mahbub Mayukh Rishad, SM Kawser Zafor Prince, Miftahul Jannat, Tazbiha Rahman Khan, Talha Islam Zinan, Tanvir Jeshan, Md. Alamgir Kabir
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Thus, the study was designed to evaluate the types of inherited haemoglobin disorders among the patients attending the haematology outdoor of Dhaka Medical College Hospital (DMCH).\nMethods: This hospital-based cross-sectional study was conducted at the Department of Haematology in DMCH, for a period of 6 months (June 2022 to November 2022. People attending the Haematology outpatient department and diagnosed with a case of inherited Hb disorder were approached for inclusion. Written informed consent was taken from each subject. Ethical issues were ensured properly. For the study, a total of 100 patients were interviewed for less than 30 minutes of duration in each case. Relevant investigations such as, Hemoglobin (Hb), Red Cell Count (RCC), MCV, MCH, MCHC, RDW, Reticulocyte, Serum ferritin were done in the Haematology lab of DMCH, and data were collected in a semi-structured questionnaire. 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引用次数: 0

摘要

背景:遗传性血红蛋白(Hb)疾病是最常见的遗传性遗传病,全球健康负担日益加重,尤其是在低收入和中等收入国家。这种疾病主要是由珠蛋白基因的点突变引起的,导致单氨基酸取代,从而导致珠蛋白链产生缺陷或正常血红蛋白的产生减少。尽管这个国家关于这个问题的研究有限,但患有遗传性Hb疾病的个人数量不容忽视。因此,本研究旨在评估达卡医学院附属医院(DMCH)室外血液科患者的遗传性血红蛋白疾病类型。方法:这项以医院为基础的横断面研究在DMCH血液科进行,为期6个月(2022年6月至2022年11月)。参加血液科门诊并被诊断为遗传性Hb疾病的患者被纳入研究。每位受试者均获得书面知情同意书。道德问题得到妥善保障。在这项研究中,总共有100名患者接受了不到30分钟的采访。在DMCH血液学实验室进行血红蛋白(Hb)、红细胞计数(RCC)、MCV、MCH、MCHC、RDW、网织红细胞(Reticulocyte)、血清铁蛋白(ferritin)等相关调查,并采用半结构化问卷收集数据。收集的数据采用SPSS 21进行统计分析。结果:在100例遗传性Hb疾病患者中,大多数(60%或60%)来自14 - 24岁年龄组。患者平均年龄38.78±6.09岁,年龄范围15 ~ 51岁。男女比例为1:1。大多数(58%)来自农村地区,42%来自城市地区。Hb平均值为10.54;其次是MCV(63.25)、MCH(22.18)、S铁蛋白(140.43)。大多数患者出现临床症状的时间为5年。在所有受试者中,三分之二的患者(66或66%)患有Hb E病,其次是14%的β型地中海贫血,14%的Hb E特征和6%的b型地中海贫血。地中海贫血的类型与受试者的年龄和性别没有关联。结论:不考虑年龄和性别差异,Hb E病是三级保健医院室外血液科就诊的患者中最常见的遗传性血红蛋白疾病。[J]中华医学杂志2023;24 (2): 96 - 105
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Types of Inherited Hemoglobin Disorders Among the Patients Attending Hematology Outdoor of a Tertiary Care Hospital in Bangladesh
Background: Inherited Haemoglobin (Hb) disorders are the most frequent genetic hereditary disorders with an increasing global health burden, especially in low- and middle-income countries. This disorder is mostly caused by a point mutation on a globin gene resulting mostly in single amino acid substitutions and consequently defective globin chain production or reduced production of normal haemoglobin. Despite the limited study of this country regarding this issue, the number of individuals suffering from inherited Hb disorders is not negligible. Thus, the study was designed to evaluate the types of inherited haemoglobin disorders among the patients attending the haematology outdoor of Dhaka Medical College Hospital (DMCH). Methods: This hospital-based cross-sectional study was conducted at the Department of Haematology in DMCH, for a period of 6 months (June 2022 to November 2022. People attending the Haematology outpatient department and diagnosed with a case of inherited Hb disorder were approached for inclusion. Written informed consent was taken from each subject. Ethical issues were ensured properly. For the study, a total of 100 patients were interviewed for less than 30 minutes of duration in each case. Relevant investigations such as, Hemoglobin (Hb), Red Cell Count (RCC), MCV, MCH, MCHC, RDW, Reticulocyte, Serum ferritin were done in the Haematology lab of DMCH, and data were collected in a semi-structured questionnaire. Collected Data were analyzed by SPSS 21. Results: Out of 100 inherited Hb disorder subjects, the majority (60 or 60%) were from the age group of 14 to 24 years. The mean age of patients was 38.78 ± 6.09 with range 15-51 years. The male-female ratio was 1:1. The majority (58%) came from rural areas and 42% came from urban areas. Mean value of Hb was 10.54; subsequently, MCV (63.25), MCH (22.18), S ferritin (140.43). The majority of patients had their onset of clinical presentation of illness for 5 years. Among total subjects, two-thirds of the patients (66 or 66%) had Hb E Disease followed by 14% Beta thalassaemia trait, 14% Hb E trait, and 6% b thalassaemia major. No association was noted between the type of thalassaemia with age & sex of the subjects. Conclusion: Irrespective of age and sex variations, Hb E disease is the most frequent inherited haemoglobin disorder among the patient attending the haematology outdoor of a tertiary care hospital. J MEDICINE 2023; 24(2): 96-105
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