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您现在的位置:首页 => 在线期刊 => 2015年 5期 胰腺疾病 => 其他 =>溶血性黄疸患者实验室检测结果分析
溶血性黄疸患者实验室检测结果分析
Laboratory analysis of hemolytic jaundice
文章发布日期:2015年05月09日  来源:  作者:李红萍,李培培,朱兆均,等  点击次数:2447次  下载次数:388次

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【摘要】:目的从实验室的角度分析溶血性黄疸的特点,为临床鉴别诊断溶血性黄疸提供实验室依据。方法选取2011年6月-2013年12月在广州医科大学附属沙井医院就诊的44例患者,其中包括遗传性溶血性疾病和溶血性疾病合并肝炎病毒感染的患者,对实验室检查结果包括血液学检查,生化指标和葡萄糖-6-磷酸脱氢酶(G-6-PD)活性等进行分析。结果G-6-PD缺乏症所致的溶血性黄疸,患者不一定有贫血表现。地中海贫血所致的溶血性黄疸,绝大多数患者红细胞呈小细胞低色素,平均红细胞体积(MCV)和平均红细胞血红蛋白含量(MCH)低于正常,α-地中海贫血血红蛋白(Hb)A2偏低,β-地中海贫血Hb A2增高。溶血性黄疸网织红细胞可增高也可在正常范围内。尿液检查胆红素呈阴性,尿胆原含量正常或增高。生化检查非结合胆红素轻中度增高,结合胆红素正常,间接胆红素的量占到总胆红素量的70%~80%。ALT、AST、ALP基本正常。溶血性黄疸患者合并肝炎病毒感染时,ALT、AST、ALP、GGT、总胆红素、直接胆红素、间接胆红素可显著升高。结论对原因不明或者不能用肝炎解释的黄疸以及轻中度黄疸,间接胆红素占到总胆红素的70%~80%的患者,都应该警惕溶血性疾病的可能,建议作G-6-PD酶活性测定和血红蛋白电泳筛查。
【Abstract】:ObjectiveTo provide a basis for clinical differential diagnosis of hemolytic jaundice based on laboratory analysis of the characteristics of this disease. MethodsA total of 44 patients with hemolytic jaundice, who suffered from hereditary hemolytic disorders or hemolytic disorders with hepatitis virus infection and were admitted to Shajing Hospital affiliated to Guangzhou Medical University from June 2011 to December 2013, underwent multiple laboratory tests. Analysis was performed on the laboratory results, including hematological tests, biochemical markers, and glucose-6-phosphate dehydrogenase (G-6-PD) activity. ResultsPatients with G-6-PD deficiency-associated hemolytic jaundice might not have anemia. Most patients with thalassemia-associated hemolytic jaundice developed microcytic hypochromic anemia with mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) lower than normal values. Hemoglobin A2 (Hb A2) was reduced in patients with alpha-thalassemia but increased in those with beta-thalassemia. Reticulocytes could be within or above normal limits. As for urine tests, urobilirubin was negative and urobilinogen level was normal or elevated. Biochemical results showed normal direct bilirubin (DB) and mildly or moderately increased indirect bilirubin (IB) that accounted for 70%-80% of total bilirubin (TB). Alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP) appeared normal. For hemolytic jaundice patients complicated with hepatitis virus infection, a number of indices, including ALT, AST, ALP, gamma-glutamyl transpeptidase, TB, DB and IB, showed significant elevation. ConclusionFor patients with jaundice of unknown origin or not attributed to hepatitis, as well as those with mild or moderate jaundice with IB accounting for 70%-80% of TB, hemolytic diseases should be considered, and G-6-PD activity test and Hb electrophoresis screening are recommended.
【关键字】:贫血,溶血性;葡萄糖-6-磷酸脱氢酶缺乏症;地中海贫血;实验室技术和方法
【Key words】:anemia, hemolytic; glucose-phosphate dehydrogenase deficiency; thalassaemia; laboratory techniques and procedures
【引证本文】:

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