Epidemiological Study on Thalassaemia Among the Children Under 7 Years Old From Yunnan Province With Unique Ethnic Minority Origin

doi:10.3877/cma.j.issn.1673-5250.2013.03.013

Objective

To investigate the epidemiological status of Thalassaemia among the children under 7 years old from Yunnan province with 15 unique ethnic minority.

Methods

From June 2009 to September 2011, blood samples from 14 088 children were tested by blood cell automatic analysis, hemoglobin electrophoresis, and genetic analysis. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Yunnan Provincial Maternal and Child Health Hospital. Informed consent was obtained from all participates' parents.

Results

The incidence rates of Thalassaemia, β-Thalassemia and α-Thalassemia were 20.9%(1793/8559), 11.3%(964/8559), and 9.7%(829/8559), respectively. Significant difference were also detected among children from different ethnic groups as well as regions. The detection rate of Thalassaemia of border areas was higher than that of non-border areas. The highest detection rate of all the regions was 43.1% in Dehong city, followed by 33.7% in Xishuangbanna, 26.3% in Nujiang, 10.7% in Lincang, 9.8% in Baoshang.

Conclusions

Occurrence of Thalassemia varies substantially between different ethnic groups as well as regions, especially Southwestern areas. This study may provide a valuable basis for counseling of Thalassemia in Yunnan province.

Key words: child, Thalassaemia, ethnic minority, epidemiology, Yunnan

表1 各民族7岁以下儿童血液样本抽样范围、地点及样本量

Table 1 The general information of children under 7 years old among different ethnics

州、市	民族	县(市)	样本量(人)
大理州	白族	大理市、剑川县	900
红河州	哈尼族	元阳县	900
西双版纳州	傣族	景洪市、勐海县、勐腊县	900
	布朗族	勐海县-布朗乡	350
	基诺族	景洪市-基诺山	350
德宏州	傣族	潞西市、瑞丽市、梁河县、盈江县、陇川县	900
	德昂族	潞西市-三台山乡	350
	阿昌族	梁河县、陇川县	350
	景颇族	潞西市、陇川县	500
怒江州	普米族	兰坪县	350
	怒族	福贡县、贡山县	350
	独龙族	贡山县-独龙江乡	350
	傈僳族	泸水县	500
临沧市	佤族	沧源县	900
普洱市	拉祜族	澜沧县、孟连县	900
丽江市	纳西族	玉龙县	900
玉溪市	花腰傣	新平县-漠沙镇	500
保山市	汉族	隆阳区、腾冲县	900

表1 各民族7岁以下儿童血液样本抽样范围、地点及样本量

Table 1 The general information of children under 7 years old among different ethnics

州、市	民族	县(市)	样本量(人)
大理州	白族	大理市、剑川县	900
红河州	哈尼族	元阳县	900
西双版纳州	傣族	景洪市、勐海县、勐腊县	900
	布朗族	勐海县-布朗乡	350
	基诺族	景洪市-基诺山	350
德宏州	傣族	潞西市、瑞丽市、梁河县、盈江县、陇川县	900
	德昂族	潞西市-三台山乡	350
	阿昌族	梁河县、陇川县	350
	景颇族	潞西市、陇川县	500
怒江州	普米族	兰坪县	350
	怒族	福贡县、贡山县	350
	独龙族	贡山县-独龙江乡	350
	傈僳族	泸水县	500
临沧市	佤族	沧源县	900
普洱市	拉祜族	澜沧县、孟连县	900
丽江市	纳西族	玉龙县	900
玉溪市	花腰傣	新平县-漠沙镇	500
保山市	汉族	隆阳区、腾冲县	900

表2 地中海贫血患者的血红蛋白电泳分析结果[n(%)]

Table 2 Results of hemoglobin electrophoresis of Thalassaemia among 8559 cases[n(%)]

州(市)	n	α-地中海贫血(HbA₂<2.5%)	β-地中海贫血(HbA₂>3.5%)	合计	P
西双版纳州	1943	318(16.4)	336(17.3)	654(33.6)	>0.05
德宏州	1278	156(12.2)	395(30.9)	551(43.1)	<0.05
怒江州	964	156(16.2)	98(10.2)	254(26.3)	<0.05
临沧市	543	54 (9.9)	4 (0.7)	58(10.7)	>0.05
玉溪市	493	43 (8.7)	32 (6.5)	75(15.2)	>0.05
普洱市	962	21 (2.2)	20 (2.1)	41 (4.3)	>0.05
丽江市	582	15 (2.6)	15 (2.6)	30 (5.2)	>0.05
大理州	298	8 (2.7)	11 (3.7)	19 (6.4)	>0.05
红河州	771	25 (3.2)	15 (1.9)	40 (5.2)	>0.05
保山市	725	33 (4.6)	38 (5.2)	71 (9.8)	>0.05
合计	8559	829 (9.7)	964(11.3)	1793(20.9)
χ²		254.561	447.651	1087.82
P		0.000	0.000	0.000

表2 地中海贫血患者的血红蛋白电泳分析结果[n(%)]

Table 2 Results of hemoglobin electrophoresis of Thalassaemia among 8559 cases[n(%)]

州(市)	n	α-地中海贫血(HbA₂<2.5%)	β-地中海贫血(HbA₂>3.5%)	合计	P
西双版纳州	1943	318(16.4)	336(17.3)	654(33.6)	>0.05
德宏州	1278	156(12.2)	395(30.9)	551(43.1)	<0.05
怒江州	964	156(16.2)	98(10.2)	254(26.3)	<0.05
临沧市	543	54 (9.9)	4 (0.7)	58(10.7)	>0.05
玉溪市	493	43 (8.7)	32 (6.5)	75(15.2)	>0.05
普洱市	962	21 (2.2)	20 (2.1)	41 (4.3)	>0.05
丽江市	582	15 (2.6)	15 (2.6)	30 (5.2)	>0.05
大理州	298	8 (2.7)	11 (3.7)	19 (6.4)	>0.05
红河州	771	25 (3.2)	15 (1.9)	40 (5.2)	>0.05
保山市	725	33 (4.6)	38 (5.2)	71 (9.8)	>0.05
合计	8559	829 (9.7)	964(11.3)	1793(20.9)
χ²		254.561	447.651	1087.82
P		0.000	0.000	0.000

表3 不同地区同一民族地中海贫血分析结果[n(%)]

Table 3 Results of Thalassaemia in different parts of the same ethnic

州(市)	民族	调查数	β-地中海贫血	α-地中海贫血
西双版纳州	傣族	1024	219(21.4)	266(26.0)
德宏州	傣族	509	134(26.3)	67(13.2)
χ²			14.72	16.97
P			<0.01	<0.01
德宏州芒市	景颇族	89	32(36.0)	29(32.6)
德宏州陇川县	景颇族	196	69(35.2)	17 (8.7)
χ²			0.02	23.99
P			>0.05	<0.01
德宏州芒市	德昂族	81	22(27.2)	8 (9.9)
德宏州瑞丽市	德昂族	143	56(39.2)	13 (9.1)
χ²			3.28	6.04
P			<0.01	>0.05
德宏州梁河县	阿昌族	51	17(33.3)	0 (0.0)
德宏州瑞丽市	阿昌族	45	22(48.9)	2 (4.4)
χ²			2.40	－
P			<0.01	>0.05

表3 不同地区同一民族地中海贫血分析结果[n(%)]

Table 3 Results of Thalassaemia in different parts of the same ethnic

州(市)	民族	调查数	β-地中海贫血	α-地中海贫血
西双版纳州	傣族	1024	219(21.4)	266(26.0)
德宏州	傣族	509	134(26.3)	67(13.2)
χ²			14.72	16.97
P			<0.01	<0.01
德宏州芒市	景颇族	89	32(36.0)	29(32.6)
德宏州陇川县	景颇族	196	69(35.2)	17 (8.7)
χ²			0.02	23.99
P			>0.05	<0.01
德宏州芒市	德昂族	81	22(27.2)	8 (9.9)
德宏州瑞丽市	德昂族	143	56(39.2)	13 (9.1)
χ²			3.28	6.04
P			<0.01	>0.05
德宏州梁河县	阿昌族	51	17(33.3)	0 (0.0)
德宏州瑞丽市	阿昌族	45	22(48.9)	2 (4.4)
χ²			2.40	－
P			<0.01	>0.05

表4 不同民族的地中海贫血的血红蛋白电泳分析结果[n(%)]

Table 4 Results of hemoglobin electrophoresis of Thalassaemia of different nationalities[n(%)]

民族	n	α-地中海贫血(HbA₂<2.5%)	β-地中海贫血(HbA₂>3.5%)	合计
景颇族	284	45(15.8)	101(35.6)	146(51.4)
德昂族	224	21 (9.4)	78(34.8)	99(44.2)
阿昌族	96	2 (2.1)	39(40.6)	41(42.7)
傣族	1998	355(17.8)	373(18.7)	728(36.4)
傈僳族	231	33(14.5)	43(18.6)	76(32.8)
基诺族	182	6 (3.3)	52(28.6)	58(31.9)
怒族	291	55(18.9)	30(10.3)	85(29.2)
独龙族	202	39(19.3)	5 (2.5)	44(21.8)
普米族	134	14(10.4)	7 (5.2)	21(15.7)
布朗族	410	17 (4.1)	26 (6.3)	43(10.5)
佤族	513	48 (9.4)	4 (0.8)	52(10.1)
汉族	764	37 (4.8)	39 (5.1)	76 (9.9)
白族	283	8 (2.8)	11 (3.9)	19 (6.7)
哈尼族	791	30 (3.8)	16 (2.0)	46 (5.8)
纳西族	495	14 (2.8)	13 (2.6)	27 (5.5)
拉祜族	744	17 (2.3)	15 (2.0)	32 (4.3)
父母民族不同	849	84 (9.9)	111(13.1)	195(23.0)
其他民族	44	3 (6.8)	1 (2.3)	4 (9.1)
合计	8559	829 (9.7)	964(11.3)	1793(20.9)
χ²		387.57	860.40	1065.17
P		0.000	0.000	0.000

表4 不同民族的地中海贫血的血红蛋白电泳分析结果[n(%)]

Table 4 Results of hemoglobin electrophoresis of Thalassaemia of different nationalities[n(%)]

民族	n	α-地中海贫血(HbA₂<2.5%)	β-地中海贫血(HbA₂>3.5%)	合计
景颇族	284	45(15.8)	101(35.6)	146(51.4)
德昂族	224	21 (9.4)	78(34.8)	99(44.2)
阿昌族	96	2 (2.1)	39(40.6)	41(42.7)
傣族	1998	355(17.8)	373(18.7)	728(36.4)
傈僳族	231	33(14.5)	43(18.6)	76(32.8)
基诺族	182	6 (3.3)	52(28.6)	58(31.9)
怒族	291	55(18.9)	30(10.3)	85(29.2)
独龙族	202	39(19.3)	5 (2.5)	44(21.8)
普米族	134	14(10.4)	7 (5.2)	21(15.7)
布朗族	410	17 (4.1)	26 (6.3)	43(10.5)
佤族	513	48 (9.4)	4 (0.8)	52(10.1)
汉族	764	37 (4.8)	39 (5.1)	76 (9.9)
白族	283	8 (2.8)	11 (3.9)	19 (6.7)
哈尼族	791	30 (3.8)	16 (2.0)	46 (5.8)
纳西族	495	14 (2.8)	13 (2.6)	27 (5.5)
拉祜族	744	17 (2.3)	15 (2.0)	32 (4.3)
父母民族不同	849	84 (9.9)	111(13.1)	195(23.0)
其他民族	44	3 (6.8)	1 (2.3)	4 (9.1)
合计	8559	829 (9.7)	964(11.3)	1793(20.9)
χ²		387.57	860.40	1065.17
P		0.000	0.000	0.000

表5 云南省10州(市)地中海贫血、G6PD缺乏症发病率与地理气候的情况

Table 5 Situation among Thalassaemia, G6PD, geography and climate of Yunnan Province

地区		α-地中海贫血(%)	β-地中海贫血(%)	G6PD缺乏症(%)	气温(℃)	纬度	海拔(m)
西双版纳州
	景洪市	3.1	29.3	1.7	21.7	21°27'	520
	勐海县	15.2	9.3	1.5	18.1	22°29'	560
	勐腊县	25.6	26.7	3.4	20.9	21°80'	480
德宏州
	芒市	19.9	30.1	6.9	19.5	24°22'	783
	梁河县	0.0	31.7	7.2	18.3	24°45'	1100
	盈江县	2.2	27.3	7.9	19.3	24°73'	210
	陇川县	7.7	38.9	5.5	18.9	24°24'	930
	瑞丽市	8.8	25.6	6.7	20.0	23°82'	723
怒江州
	贡山县	17.9	2.6	0.0	14.8	25°45'	1300
	福贡县	16.7	10.5	2.5	15.0	26°30'	1000
	泸水县	16.7	4.0	0.5	17.0	25°50'	700
	兰坪县	11.6	5.8	0.0	11.3	26°50'	2200
临沧市
	沧源县	9.9	0.8	0.4	17.4	23°10'	1000
	玉溪市
	新平县	8.7	6.5	8.3	17.3	23°50'	600
普洱市
	孟连县	2.7	2.7	0.7	19.6	22°20'	1000
	澜沧县	1.7	1.5	0.9	18.9	22°40'	1800
丽江市
	玉龙县	2.8	2.6	2.1	12.6	27°00'	2000
大理州
	剑川县	7.7	7.7	0.2	12.2	26°30'	2200
	大理市	1.3	2.6	0.5	15.3	25°50'	1976
红河州
	元阳县	3.2	1.9	0.9	16.4	23°19'	2534
保山市
	隆阳区	4.8	4.4	0.6	15.5	25°12'	1800
	腾冲县	6.4	5.0	0.7	14.8	25°10'	1600

表5 云南省10州(市)地中海贫血、G6PD缺乏症发病率与地理气候的情况

Table 5 Situation among Thalassaemia, G6PD, geography and climate of Yunnan Province

地区		α-地中海贫血(%)	β-地中海贫血(%)	G6PD缺乏症(%)	气温(℃)	纬度	海拔(m)
西双版纳州
	景洪市	3.1	29.3	1.7	21.7	21°27'	520
	勐海县	15.2	9.3	1.5	18.1	22°29'	560
	勐腊县	25.6	26.7	3.4	20.9	21°80'	480
德宏州
	芒市	19.9	30.1	6.9	19.5	24°22'	783
	梁河县	0.0	31.7	7.2	18.3	24°45'	1100
	盈江县	2.2	27.3	7.9	19.3	24°73'	210
	陇川县	7.7	38.9	5.5	18.9	24°24'	930
	瑞丽市	8.8	25.6	6.7	20.0	23°82'	723
怒江州
	贡山县	17.9	2.6	0.0	14.8	25°45'	1300
	福贡县	16.7	10.5	2.5	15.0	26°30'	1000
	泸水县	16.7	4.0	0.5	17.0	25°50'	700
	兰坪县	11.6	5.8	0.0	11.3	26°50'	2200
临沧市
	沧源县	9.9	0.8	0.4	17.4	23°10'	1000
	玉溪市
	新平县	8.7	6.5	8.3	17.3	23°50'	600
普洱市
	孟连县	2.7	2.7	0.7	19.6	22°20'	1000
	澜沧县	1.7	1.5	0.9	18.9	22°40'	1800
丽江市
	玉龙县	2.8	2.6	2.1	12.6	27°00'	2000
大理州
	剑川县	7.7	7.7	0.2	12.2	26°30'	2200
	大理市	1.3	2.6	0.5	15.3	25°50'	1976
红河州
	元阳县	3.2	1.9	0.9	16.4	23°19'	2534
保山市
	隆阳区	4.8	4.4	0.6	15.5	25°12'	1800
	腾冲县	6.4	5.0	0.7	14.8	25°10'	1600

[1]	Cooperative Research Group Haemoglobinopathies of Eighteen Provinces (autonomous regions and municipalities).Epidemiological study on hemoglobin disease and glucose-6-phosphate dehydrogenase deficiency of eighteen provinces (autonomous regions and municipalities)[J]. Chin J Hematol, 1985, 6:450-459.
[2]	Institute of hematology of Chinese Academy of Medical Sciences. Comprehensive analysis of abnormal hemoglobin epidemiology[J].
[3]	Xie YQ, ed. Minority ethnic group in Yunnan province[M]. Beijing: Nationalities Publishing House, 1999, 1-2.
[4]	National Cooperative Research Group Haemoglobinopathies. To investigation hemoglobin disease of 60 million in 20 provinces, municipalities and autonomous regions[J]. Natl Med J Chin, 1983, 63:382-385.
[5]	Guo YM Huang ZH, Peng H. Hemoglobin electrophoresis of thalassemia of minority ethnic group of Xishuangbanna region[J]. New Med J, 2008, 5(6):928.
[6]	Song WF, Wang N, Qiu ZM, et al. Investigation on hemoglobinopathy among minority in Lijiang city, Yunnan province[J]. Academic J Kunming Med Coll, 1991, 12(3):60-68.
[7]	Zhu SH, Kong FL, Xu WB. Investigation on hemoglobinopathy of Yuxi region[J]. J Dali Med Coll, 1994, 6(1):29-32.
[8]	Yin BR, Yang GY. Investigation on hemoglobinopathy[J]. Chin J Hematol, 1983, 4(3):104.
[9]	Guan PS, Wang MF, Li GT, et al. Investigation on hemoglobinopathy among students of primary school and junior school of Ha'ni group[J]. Med Pharm Yunnan, 1987, 2:82-84.
[10]	Zhao ZM, Yao LQ, Fan LM, et al. Epidemiological study on thalassemia among the children of 0-7 years old among the six ethnic groups in Xishuangbanna and Dehong of Yunnan province[J]. Chin J Epidemiol, 2011, 32(4):352-356.
[11]	Zhang ZX, Cheng YG. Human genetic diseases and malaria congenital immunity[J]. J Pract Parasit Dis, 2002, 10(2):76-78.

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