非缺失型血红蛋白H病患者尿酸水平及相关因素分析  

Urid Acid Level in Patients with Non-deletional Hemoglobin H Disease and Risk Factors

作　　者：李静[1] 尹晓林[1] 张新华[1] 周亚丽[1] 张天朗[1] 罗瑞贵[1] 黄慧婷[1] 

机构地区：[1]解放军303医院血液科,广西南宁530021

出　　处：《华南国防医学杂志》2013年第4期241-243,共3页Military Medical Journal of South China

基　　金：广西自然科学基金项目(2012GXNSFDA053018)

摘　　要：目的观察非缺失型血红蛋白H病(hemoglobin H disease,HbH)患者尿酸水平,并分析其相关因素。方法 116例经基因分型诊断为非缺失型HbH病患者检测血红蛋白(hemoglobin,Hb)浓度、血尿酸(serum uric acid,sUA)、乳酸脱氢酶(lactate dehydrogenase,LDH)、总胆红素(total bilirubin,TBIL)、间接胆红素(indirect bilirubin,IBIL)等,行统计学分析。结果 116例患者中男性切脾组45例、未切脾组25例,女性切脾组33例、未切脾组13例,高尿酸血症的发生率分别为20.0%、44.0%、24.2%和38.5%。无论男性还是女性患者,切脾组Hb浓度均高于未切脾组[男性:(91.6±13.3)g/L vs.(80.8±25.5)g/L,P=0.022;女性:(90.1±6.9)g/L vs.(75.4±9.4)g/L,P<0.001];尿酸水平低于未切脾组[男性:(352.1±110.1)μmol/L vs.(414.8±140.1)μmol/L,P=0.043,女性(296.4±87.9)μmol/L vs.(376.8±96.2)μmol/L,P=0.014];LDH低于未切脾组[男性:(268.2±236.5)IU/L vs.(443.8±354.9)IU/L,P=0.017,女性:(227.4±127.8)IU/L vs.(475.5±134.8)IU/L,P<0.001]。相关分析表明,血清尿酸水平与切脾相关(r=-0.288,P=0.002)、LDH水平(r=-0.352,P=0.000),而与性别、年龄、网织红细胞计数(reticulocyte count,RET)、Hb水平无显著性相关。结论非缺失型HbH患者存在高尿酸代谢,切脾可以减少红细胞的破坏、降低尿酸水平。Objective To investigate the level of uric acid in patients with non-deletional hemoglobin H disease （HbH disease） and the risk factors. Methods One hundred and sixteen patients with non-deletional HbH disease diag- nosed by genotype were studied. Hemoglobin concentration, serum uric acid, lactate dehydrogenase （LDH）, total bilirubin and indirect bilirubin level were detected and analysed. Results Among 116 patients, 45 male patients were splenecto- mized,25 male patients were not splenectomized,33 female patients splenectomized and 13 female patients not splenecto- mized. Frequencies of hyperuricemia were 20. 0%, 44. 0~, 24. 2% and 38.5% respectively. In either male or female pa- tients,the splenectomized patients had higher hemoglobin concentration （in male, （91.6 ＋ 13.3）g/L vs. （80. 8 -＋ 25.5） g/L,P = O. 022; in female, （90. 1 ＋ 6. 9）g/L vs. （75.4 ＋ 9. 4 ）g/L,P^0. 001 ）, lower uric acid （in male, （352. 1 ＋ 110. 1） /~mol/L vs. （414. 8 ＋ 140. 1） t^mol/L, P = 0. 043~ in female, （296. 4 ＋ 87. 9） /~mol/L vs. （376. 8 -＋ 96. 2） tlmol/L, P = 0. 014） ,and lower LDH level （in male, （268. 2 -＋ 236. 5） IU/L vs. （443. 8 ＋ 354. 9）IU/L,P = 0. 017; in female, （227. 4 -＋ 127.8） IU/L vs. （475.5 ＋- 134. 8） IU/L,P%0. 001）. The correlation analyses indicated that the uric acid level was signif- icantly correlated with splenectomy （r = - 0. 288, P = 0. 002） and LDH level （r = - 0. 352,P = 0. 000）, but not correlated with gender,age,reticulocyte count and hemoglobin level. Conclusion Patients with non-deletional HbH disease have high uric acid level. Splenectomy can decrease the injury of red cells and uric acid level.

关 键 词：血红蛋白H病 尿酸 脾脏切除术 

分 类 号：R556.7[医药卫生—血液循环系统疾病]