内科理论与实践 ›› 2021, Vol. 16 ›› Issue (05): 354-358.doi: 10.16138/j.1673-6087.2021.05.013
收稿日期:
2021-07-02
出版日期:
2021-10-20
发布日期:
2022-07-25
通讯作者:
韩悦
E-mail:hy11521@rjh.com.cn
基金资助:
Received:
2021-07-02
Online:
2021-10-20
Published:
2022-07-25
中图分类号:
姚碧莲, 张欣欣, 韩悦. 肝豆状核变性的基因诊断研究进展[J]. 内科理论与实践, 2021, 16(05): 354-358.
表1
ATP7B突变与临床表型
突变类型 | 临床表现特点 | 参考文献 |
---|---|---|
p.R778L | 发病年龄早,铜蓝蛋白及血清铜水平低 | [ |
p.R919G | 神经系统症状为主,铜蓝蛋白水平较高 | [ |
p.T935M | 同时具有神经系统和肝脏病变,铜蓝蛋白水平较高 | [ |
p.L492S、p.V519M、p.E541K、p.L549P、p.A604P、p.R616W、p.P992L、p.N1270S | 发病年龄较早 | [ |
p.I1148T | 12岁后发病 | [ |
p.M769Hfs*26 | 肝脏疾病症状表现较多 | [ |
p.H1069Q/ p.M769Hfs*26 | 构音障碍及吞咽困难等症状表现较多 | [ |
p.A1003T | 神经系统疾病密切相关 | [ |
p.S653Y | 铜蓝蛋白水平正常 | [ |
移码突变、无义突变、缺失突变 | 铜蓝蛋白水平低 | [ |
大片段缺失突变 | 发病年龄早,多存在较为严重的肝脏病变 (如进行性肝炎、肝硬化、肝衰竭) | [ |
表2
修饰基因突变与临床表型
修饰基因 | 突变位点 | 临床表型 | 参考文献 |
---|---|---|---|
COMMD1 | p.D164D | 神经和肝脏症状早发 | [ |
SOD2 | p.V16A | 男性发病早 | [ |
CAT | c.262C>T | 男性发病晚 | [ |
BDNF | p.Y90Y | 平均发病年龄推迟 | [ |
ApoE | ε3基因型 ε4基因型 | 发病较晚 女性患者临床症状表现早 | [ [ |
PRNP | p.M129V | 与神经系统表型相关 | [ |
ESD | 增加神经症状风险 | [ | |
染色体重塑因子INO80 | 降低神经症状风险 | [ | |
ATOX1 | 5'UTR-99 T>C | 发病较早 | [ |
XIAP | p.T470S p.N340S | 发病较早 | [ |
PNPLA3 | rs738409 | 与中/重度肝脏脂肪变相关 | [ |
MTHFR | 667T 1298C | 与肝脏表型相关发病年龄较早 | [ |
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