G6PD缺陷症对恶性疟疾感染风险的影响

摘要

Objective To investigate the impact of Glucose-6-phosphate dehydrogenase (G6PD) deficiency on plasmodium falciparum malaria. Methods A cross-sectional study was performed on 2 690 patients in Malabo regional hospital on Bioko Island during rainy season (2012). The plasmodium falciparum was identified by real-time PCR and oil immersion microscopy. G6PD deficiency was identified by a fluorescent spot test (FST) and PCR-DNA sequencing. Logistic regression was conducted to estimate the association between G6PD deficiency and malaria. Results The prevalence of G6PD was 9.22% in the population , all of whose genotype G6PD deficiency was G6PD*A-(c.202 G > A/c.376 A > G). Confounding factors-adjusted OR showed that G6PD deficiency provided significant protection against malaria (P < 0.05). It was found that male hemizygotes has a protective effect against malaria (P < 0.05), while the female heterozygote group and female homozygous group had no statistical difference (P > 0.05). Conclusions The results suggest that male hemizygotes could provide protection against malaria. Further studies are required to explore the molecular mechanism in malaria infection.%目的：观察葡萄糖－6－磷酸脱氢酶（G6PD）缺陷症不同表型对恶性疟原虫感染的影响。方法：采用横断面研究的方式，将2012年雨季到马拉博地区医院就诊的2690名比奥克岛当地居民纳入研究。用显微镜镜检、荧光定量 PCR 结合熔解曲线法检测疟原虫。用荧光斑点法及 PCR-DNA 测序鉴定 G6PD 缺陷症。采用 Logistic 回归进行关联性分析。结果：该人群的 G6PD 缺陷症的总发生率为9．22％，基因型均为G6PD*A－（c．202 G＞A／c．376 A＞G）。G6PD缺陷症体现出强烈的疟疾保护作用（P＜0．05）；不同性别和表型的 G6PD 缺陷者中，只有男性半合子对疟疾有保护作用（P＜0．05），而女性杂合子组与女性纯合子组均无统计学差异（P＞0．05）。结论：G6PD 缺陷症的男性半合子表型能够减低恶性疟疾感染的风险，但是其机制尚未明确，有待更深入的研究。