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[成人先天性心脏病与综合征]

[Congenital cardiopathies and syndromes in adults].

作者信息

Calderón Colmenero Juan

机构信息

Servicio Cardiología Pediátrica, Instituto Nacional de Cardiologia Ignacio Chávez, INCICH, Juan Badiano No. 1, Col. Sección XVI, Tlalpan, 14080 México, D. F.

出版信息

Arch Cardiol Mex. 2002 Jan-Mar;72 Suppl 1:S31-4.

Abstract

Among congenital defects the most common are the congenital heart defects, which constitute a heterogeneous group with a multifactor etiology. A single gene mutation has been identified in some of them, such as in of Williams's syndrome, or they can be due to teratogenic agents. The advance in diagnosis and treatment of congenital heart defects has become very important because mortality has diminished and patients live longer and better, reaching adult hood. Molecular biology offers now opportunities understand the cause of many genetic diseases thanks to molecular studies of chromosomes. Conotruncal malformations are known to be caused by a microdeletion in chromosome 22(22q11), this mutation is also responsible for the DiGeorge and cardiovelofacial syndromes, the most relevant aspects are: congenital heart disease, which is present in 75% of the cases, the leading disorder is Fallot's tetralogy with pulmonary atresia, in second place is interruption of the aortic arch type B, followed by common truncus arteriosus. These patients have other phenotypic features, such as high palate, speech problems, malimplantation of ears, and protuberant nose tip, among others. Diagnosis is made with the FISH (fluorescent in situ hybridization) test that shows a microdeletion in chromosome 22 at the 11.2 region. Another syndrome that has received great attention is the Williams-Beuren syndrome, which courses with mental retardation, hypercalcemia, characteristic facies, and supravalvular aortic and pulmonary stenosis. To day, it is known that its cause is a deletion in chromosome 7(7q11.23), which affects elastin region, in consequence, affecting the vessels.

摘要

在先天性缺陷中,最常见的是先天性心脏缺陷,这是一组病因多因素的异质性疾病。其中一些已被确定存在单基因突变,如威廉姆斯综合征,或者它们可能是由致畸剂引起的。先天性心脏缺陷的诊断和治疗进展变得非常重要,因为死亡率已经降低,患者寿命更长且生活质量更好,能够步入成年期。由于对染色体的分子研究,分子生物学现在为理解许多遗传疾病的病因提供了机会。已知圆锥动脉干畸形是由22号染色体(22q11)的微缺失引起的,这种突变也导致迪格奥尔格综合征和心脏颜面综合征,最相关的方面包括:75%的病例存在先天性心脏病,主要疾病是法洛四联症合并肺动脉闭锁,其次是B型主动脉弓中断,然后是共同动脉干。这些患者还有其他表型特征,如高腭、言语问题、耳部植入异常和鼻尖突出等。通过荧光原位杂交(FISH)检测进行诊断,该检测显示22号染色体11.2区域存在微缺失。另一个受到极大关注的综合征是威廉姆斯-贝伦综合征,其伴有智力发育迟缓、高钙血症、特征性面容以及主动脉瓣上和肺动脉狭窄。如今,已知其病因是7号染色体(7q11.23)的缺失,这影响了弹性蛋白区域,进而影响血管。

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