以肝功能不良就诊的地中海贫血患者83例临床分析

Clinical analysis of 83 cases of thalassemia complicated with liver dysfunction

目的:探讨地中海贫血合并肝功能不良患者的临床特征。方法:以2012年1月至2021年7月华中科技大学同济医学院附属同济医院收治的83例以肝功能不良就诊的地中海贫血病例为研究对象,分析其一般情况、地中海贫血基因型、血常规及肝功能、影像学等临床资料。结果:地中海贫血合并肝功能不良患者表现为谷丙转氨酶和谷草转氨酶升高、小细胞低色素性贫血,其总胆红素异常程度不一,且与基因型无关(P>0.05)。但黄疸严重的患者其红细胞及血红蛋白明显减少(P<0.05),且常易合并其他肝胆疾病,如病毒性肝炎、胆系感染等。结论:湖北地区地中海贫血基因携带也较为多见,临床医生在诊治疑难性肝病时应考虑到地中海贫血可能。

Objective:Exploring the common characteristics of thalassemia patient complicated with liver dysfunction.Methods:A total of 83 thalassemia complicated with liver dysfunction patients in Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science&Technology from January 2012 to July 2021 were included in this study,and the clinical data of them such as general condition,genotype,blood routine examination and liver function were analyzed.Results:Thalassemia patients complicated with liver dysfunction showed an increase of alanine aminotransferase and aspartate aminotransferase and microcytic hypochromic anemia.The increase of bilirubin of the patients varies,which was not related to genotype(P>0.05).However,the RBC count and Hb concentration of patients with severe icterus decreased significantly(P<0.05),who often were combined with other hepatobiliary diseases,such as viral hepatitis,biliary infection and so on.Conclusion:Thalassemia mutations are also common in Hubei,therefore,clinicians should also consider the possibility of thalassemia in the diagnosis and treatment of patients with complicated liver disease.