摘要
目的分析本地区最常见的三种基因突变型G1388A、G1376T和A95G与葡萄糖-6-磷酸脱氢酶(G-6-PD)活性之间的相关性,并探讨G-6-PD基因突变对新生儿黄疸的影响。方法124例广西南宁的高胆红素血症新生儿为研究对象。应用突变特异性扩增系统法检测G-6-PD基因突变,应用硝基四氮唑蓝(NBT)定量法检测G-6-PD活性。比较G-6-PD不同基因突变型之间以及与正常组之间胆红素脑病发生率、出生72h后血清胆红素峰值组间的差异。采用非条件logistic回归分析血清胆红素值>340μmol/L的危险度。结果124例中有37例G-6-PD基因突变(G1388A20例,G1376T14例,A95G4例,1例同时存在G1388A与A95G突变)。20例G1388A突变者中5例(25%)G-6-PD酶活性正常,14例G1376T突变者中4例(29%)G-6-PD酶活性正常,4例A95G突变者G-6-PD酶活性均缺乏。G1388A与G1376T组胆红素脑病发生率及出生72h后血清胆红素峰值差异无显著性。G-6-PD突变组出生72h后血清胆红素峰值、胆红素脑病发生率及血清胆红素>340μmol/L的危险度与G-6-PD正常组相比,差异无显著性。结论广西南宁地区G-6-PD突变仍常见G1388A、G1376T和A95G基因型。NBT法诊断G-6-PD缺乏存在假阴性。不同基因型对出生72h后血清胆红素峰值、胆红素脑病发生率的影响无差异。单独的G-6-PD基因突变对生后72h血清胆红素峰值、急性胆红素脑病发生率及血清胆红素大于340μmol/L危险性均无影响。
Objective To study the correlation between glucose-6-phosphate dehydrogenase（G-6-PD）activities and three common mutations of G-6-PD gene G1388A,G1376T and A95G and investigate the effects of G-6-PD gene mutations on neonatal jaundice in Nanning,Guangxi.Methods One hundred and twenty-four neonates from Nanning,Guangxi,with hyperbilirubinemia were enrolled.The ARMS-PCR and PCR/REA methods were used to determine G-6-PD gene mutations.G-6-PD activities were measured using the NBT method.The incidence of acute bilirubin encephalopathy and the peak bilirubin concentration 72 hrs after birth were compared between the neonates with different genotypes and between the G-6-PD mutation and normal groups.The risk of blood serum bilirubin 〉340 μmol/L was evaluated by logistic regression analysis.Results Of the 124 cases,gene mutations were found in 37 cases,including G1388A（n=20）,G1376T（n=14）,A95G（n=4）and G1388A＋A95G（n=1）.Five cases（25%）showed normal G-6-PD activities in the G1388A gene mutation group and 4（29%）had normal G-6-PD activities in the G1376T G1388A gene mutation group.All of 4 cases of A95G G1388A gene mutation showed a deficiency of G-6-PD activities.There were no significant differences in the incidence of acute bilirubin encephalopathy and the peak bilirubin concentration 72 hrs after birth between the G1388A and G1376T G1388A gene mutation groups.The incidence of acute bilirubin encephalopathy,the peak bilirubin concentration 72 hrs after birth and the risk of serum bilirubin 〉340 μmol/L in the G-6-PD mutation group were not different from the normal group.Conclusions G1388A,G1376T and A95G are common G-6-PD gene mutations in Nanning,Guangxi.The false negative results may be received when the NBT method is used for diagnosis of G-6-PD deficiency.There are similar effects on the incidence of acute bilirubin encephalopathy and the peak bilirubin concentration 72 hrs after birth between different gene mutation groups.G-6-PD gene mutations alone may not contribute to the development of acute bilirubin encephalopathy and the changes of peak bilirubin concentration 72 hrs after birth and the risk of serum bilirubin 〉340 μmol/L.
出处
《中国当代儿科杂志》
CAS
CSCD
北大核心
2009年第12期970-972,共3页
Chinese Journal of Contemporary Pediatrics
基金
广西自然科学基金资助项目(0728117)
