云南省两边境州六民族0～7岁儿童地中海贫血流行病学调查

摘要

目的 了解云南省西双版纳州(版纳州)和德宏州傣、基诺、布朗、景颇、德昂、阿昌族的0～7岁儿童地中海贫血(地贫)的流行现状.方法 对两边境州六民族7岁以下儿童共4973人进行血液分析、红细胞脆性试验、血红蛋白(Hb)电泳,并进行统计学分析.结果 4973人中地贫发生率为37.4%;其中β-地贫发生率22.6%,α-地贫发生率14.7%.地贫发生率无性别差异,但有年龄差异.α-地贫阳性率随年龄增加而降低,β-地贫阳性率随年龄增加而上升.地贫阳性率有地区差异:版纳州高于德宏州,多个县(市)之间两两比较差异有统计学意义;版纳州地贫检出率以勐腊县居首为52.2%,德宏州以潞西市居首为51.5%.不同地区不同民族地贫阳性率均有差异:β-地贫发生率阿昌族居首为40.6%,α-地贫以汉族居首为45.5%.同一地区不同民族地贫阳性率也均有明显差异.多因素分析显示,地贫(α-地贫+β-地贫)为因变量时,州(市)为危险因素,母亲民族为保护因素.结论 在云南省两边境州六民族中儿童地贫属高发区,其发生率在不同民族及地区有差异,地域差异大于民族差异;随着时间的延长,异常基因在扩散.%Objective To investigate the prevalence rate of thalassemia among children of 0-7 years old,from six ethnic groups in Xishuangbanna and Dehong.Yunnan province.Methods 4973 blood samples from children under 7 years old were automatically undergone blood cell count,red cell osmotic fragility and hemoglobin electrophoresis testings.Results The incidence rates of thalassaemia,β-thalassemia was 37.4%,and α-thalassaemia were 22.6%and 14.7% respectively.The thalassaemia incidence rates were significantly different among age groups but not in gender. The incidence of α-thalassaemia was decreasing along with the increase of age.while the incidence of β-thalassaemia was increasing along with the increase of age.Xishuangbanna had the higher incidence than in Dehong and the differences were significant between counties.The incidence of thalassemia of Mengla ranked the first(52.2%)in Xishuangbanna,The difierences between different regions and different nationalities were significant,with β-thalassemia of Achang ranked the first(40.6%),The incidence of α-thalassemia among Han ranked the first as 45.5% while α-thalassaemia and β-thalassemia were different in regions.α-thalassaemia and β-thalassemia were significantly different between different ethnic people in the same regions.Multiple factor analysis showed that region seemed to be a risk factor and the mother's ethnicity was a protective factor and dependent variable on thalassaemia.Conclusion The incidence of thalassaemia in Yunnan Xishuangbanna and Dehong was high among children under the age of 7 and were related to ethnic and regional differences in the areas.Specific genes were proliferated along with the extension of time.Our data provided valuable information on prevention and genetic studies on thalassaemia in the minorities of Xishuangbanna and Dehong in Yunnan province.