云南省地中海贫血基因携带者及患者α和β珠蛋白基因突变谱与产前基因诊断  

A study on gene mutation spectrums of α- and β-thalassemias in populations of Yunnan Province and the prenatal gene diagnosis

作　　者：朱宝生[1] 贺静[1] 张杰[1] 曾小红[1] 苏洁[1] 徐祥虎[1] 李苏云[1] 陈红[1] 章印红[1] 

机构地区：[1]云南省第一人民医院出生缺陷与遗传病研究重点实验室,昆明650032

出　　处：《中华妇产科杂志》2012年第2期85-89,共5页Chinese Journal of Obstetrics and Gynecology

基　　金：基金项目：国家自然科学基金（30760241）;云南省高层次人才培引工程（20080C009）

摘　　要：目的 调查云南省地中海贫血（地贫）患者和地贫基因携带者中,α和β珠蛋白的基因突变谱与产前基因诊断.方法 收集2009年7月-2011年7月云南省中部、西部、南部、北部、东部等5个地区的10 033例孕前咨询夫妇、孕妇及22例贫血患儿.受检者的基本信息、血红蛋白电泳、血常规和基因诊断结果,由云南省出生缺陷与遗传病研究重点实验室汇总后输入Excel软件数据库中保存.采用单管多重跨越断裂点PCR技术和PCR-反向斑点杂交试剂盒,对血液学表型筛查阳性的1077例地贫基因携带者或患者的DNA分别进行α或β珠蛋白基因常见突变类型检测；采用DNA测序技术对基因突变检测阴性病例的DNA进行α或β珠蛋白基因编码区测序,获得α和β珠蛋白基因的突变谱.对地贫高风险胎儿进行产前基因诊断.结果 （1）1077例血液学筛查表型阳性者中,检出347例α地贫患者或地贫基因携带者,对其中的119例进行α珠蛋白基因缺失和突变谱检测,共检测出5种α珠蛋白基因缺失和突变,其中104例为东南亚缺失型（--SEA）、右缺失型（-α3.7）、非缺失型（αCSα）、左缺失型（-α4.2）4种常见的α珠蛋白基因缺失突变和点突变携带者；14例为双重杂合子的血红蛋白（Hb）H病和重型α地贫患者；1例α地贫基因携带者中检测出了罕见的α2珠蛋白基因内含子的插入缺失突变α301-24_301-23 indel.（2）1077例血液学筛查表型阳性者中,检出730例β地贫患者或地贫基因携带者,对其中的297例β地贫患者或地贫基因携带者进行β珠蛋白基因缺失和突变谱检测,共检测出16种β珠蛋白基因突变,其中包含7例少见异常血红蛋白病患者的β珠蛋白基因突变,1例β地贫患者中检出Codon 5（-CT）突变.（3）对3例α地贫高风险胎儿进行了产前基因诊断,其中检出1例Hb Bart水肿综合征胎儿,基因型为--SEA/--SEA；1例轻型α地贫,基因型为αCSα/αα；Objective To investigate mutation spectrums of α- and β-haemoglobin genes in thalassemia patients and carriers in Yunnan province,and to establish procedures on prenatal gene diagnosis.Methods Totally 10 033 counseling couples and pregnant women,and 22 cases of children with moderate or severe thalassemia were recruited from 5 parts of Yunnan Province,middle,western,eastern,southern and northern areas, during July 2009 to July 2011.Medical records, including results of haemoglobin electrophoresis,blood routine examination,and gene diagnosis of subjects were collected and saved in an database in Excel software by the Key Laboratory for Birth Defects and Genetic Diseases.Using multiple gap-PCR and PCR-reversed dot blotting kits, DNA samples collected from 1077 cases of haematological positive thalassemia patients and carriers were tested to determine common mutations of the α-or β-haemoglobin genes.The codon regions of haemoglobin genes were sequenced by the Sanger sequencing in cases that the mutation tests were negative.Mutation spectrums of α- and β-haemoglobin genes were concluded.Prenatal gene diagnosis was offered to fetuses who had risk of thalassemia major.Results （ 1 ） In 1077 cases of haemological screen positive subjects,deletions and mutations of α-haemoglobin gene were tested in 119 subjects among 347 cases suspected as α-thalassemia patients and carriers.Five kinds of deletions and mutations on α-haemoglobin gene were found.In 104 subjects,four kinds of common deletions and mutations onα-haemoglobin gene were determined：--SEA, -α3.7 , αCS α,-α4.2.Other 14 subjects were double heterozygotes with haemoglobin H disease and severe α-thalassemia phenotypes.A rare mutation of insertion and deletion in α2 haemoglobin gene intron,α301-24-301-23 indel,was found in one carrier subject.（2）In 1077 cases of haemological screen positive subjects,deletions and mutations of β-haemoglobin gene were tested in 297 subjects among 730 cases suspected as β-thalassemia patients and carriers.Sixt

关 键 词：地中海贫血 珠蛋白类 产前诊断 突变 

分 类 号：R556.61[医药卫生—血液循环系统疾病]