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目的本文研究盐酸小檗碱是否会诱发红细胞G6PD酶活性缺陷患者发生溶血,为G6PD酶缺陷患者使用黄连的安全性提供参考。方法采用G6PD酶缺陷患者静脉全血,以生理盐水为空白对照,观察不同浓度盐酸小檗碱(Ber)对红细胞形态、红细胞计数(RBC)、血红蛋白(HGB)、红细胞G6PD酶活性及血浆游离血红蛋白(F-HB)的影响。结果血中Ber浓度为0.1mg/L和0.5mg/L时,红细胞形态、RBC、HGB及G6PD酶活性均无明显改变(P>0.05);Ber药物浓度为1mg/L时,红细胞形态有轻度改变,RBC、HGB下降(P<0.05),G6PD酶活性无明显变化(P>0.05);Ber浓度为5mg/L时,红细胞形态明显改变,RBC、HGB显著下降(P<0.01),红细胞G6PD酶活性显著增高(P<0.01);各浓度Ber溶液均可使F-HB显著下降(P<0.01)。结论①按正常剂量使用黄连对G6PD酶缺乏者可能是安全的,大剂量Ber能使G6PD酶缺陷患者红细胞遭到损害,提示避免超剂量使用黄连。②Ber能使血浆游离血红蛋白测定值降低,可能的原因有待进一步研究分析。
Objective To study whether berberine hydrochloride can induce hemolysis in patients with defects of erythrocyte G6PD enzyme activity and provide references for the safety of Coptis chinensis in patients with G6PD deficiency. Methods Whole venous blood was collected from patients with G6PD deficiency and normal saline was used as blank control. Berberine hydrochloride was used to observe the changes of erythrocyte morphology, erythrocyte count (RBC), hemoglobin (HGB), erythrocyte G6PD activity and plasma free hemoglobin (F-HB) effects. Results The erythrocyte morphology, RBC, HGB and G6PD activities had no significant changes (P> 0.05) when the concentration of Ber was 0.1 mg / L and 0.5 mg / L in Ber. When the concentration of Ber was 1 mg / L, the morphology of erythrocytes was light (P <0.05), and the activity of G6PD had no significant change (P> 0.05) when the concentration of RBC and HGB was decreased (P> 0.05); when the concentration of Ber was 5mg / L, the morphology of erythrocytes changed obviously; G6PD activity was significantly increased (P <0.01); F-HB significantly decreased in all concentrations of Ber (P <0.01). Conclusions ① The use of berberine at normal dosage may be safe for patients with G6PD deficiency. High doses of Ber can damage erythrocytes in patients with G6PD deficiency, suggesting that over-dosage of Coptis should be avoided. ② Ber can make plasma measured value of free hemoglobin decreased, the possible causes for further study.