Gilbert综合征11例临床分析  

An analysis of 11 cases with Gilbert′s syndrome

作　　者：蒋龙凤 刘浩[2] 许雪莲[3] 金柯 韩亚萍 章莉莉 李军[1] 董莉 

机构地区：[1]南京医科大学第一附属医院感染病科,江苏省210029 [2]南京医科大学附属南京儿童医院感染病科 [3]南京中医药大学

出　　处：《江苏医药》2014年第17期2001-2003,共3页Jiangsu Medical Journal

基　　金：江苏省卫生厅医学创新团队基金(LJ201121);"艾滋病和病毒性肝炎等重大传染病防治"科技重大专项(2013ZX10002005-002-005)

摘　　要：目的总结Gilbert综合征(GS)的临床特点、诊断和治疗。方法回顾性分析11例GS患者的临床、实验室检查、肝组织病理以及胆红素-尿嘧啶二磷酸葡萄糖醛酸转移酶(UGT)基因的检测资料。结果 11例GS患者中,有皮肤、巩膜黄染9例,无自觉症状4例,纳差伴乏力7例,右上腹不适5例,恶心呕吐2例。20岁以前发病患者的平均总胆红素(TBil)和间接胆红素(IBil)分别为123.85μmol/L和52.74μmol/L,均高于20-40岁发病者的111.85μmol/L和41.83μmol/L(P<0.05)。对1例患者行基因测序,其UGT1A1基因1号外显子存在686C>A杂合突变。结论GS患者表现为慢性反复轻度升高的IBil,临床症状轻微。临床诊断无特异性方法,UGT1A1基因检测对于GS的诊断、治疗和遗传咨询具有重要意义。Objective To analyze the clinical and pathological characteristics, diagnosis and treatment of Gilbert＇s syndrome. Methods Data of clinical material, laboratory tests, pathology of liver tissues and UGTIA1 gene analysis from 11 patients with Gilbert＇s syndrome were analyzed retrospectively. Results Of 11 patients, skin yellow sclera was seen in 9 cases, non-conscious disorder in 4 cases, anorexia accompanied by fatigue in 7 cases, right upper quadrant discomfort in 5 cases, nausea and vomiting in 2 cases. The values of TBil and IBil in the patients younger than 20 year old were 123.85 tLmol/L and 52. 74 t^mol/L, respectively, which were significantly higher than 111.85 t^mol/L and 41.83 tLmol/L in those elder than 20 year old（P^0. 05）. One patient underwent gene sequencing, which showed that the heterozygous mutation of UGTIA1 exon gene 686 C~ A exists. Conclusion The patients with Gilbert＇s syndrome show a chronic recurrent mildly elevated indirect bilirubinemia with some mild clinical symptoms. There is no specific method for the diagnose of Gilbert＇s syndrome. The UGTIA1 gene sequencing is valuable in the diagnosis, treatment and genetic counseling for Gilbert＇s syndrome.

关 键 词：GILBERT综合征 

分 类 号：R575[医药卫生—消化系统]