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[中国汉族常染色体显性遗传性多囊肾病的遗传异质性与表型]

[Genetic heterogeneity and phenotypes of autosomal dominant polycystic kidney disease in Chinese Han nationality].

作者信息

Zhang Wei-li, Mei Chang-lin

机构信息

Department of Nephrology, Shanghai Changzheng hospital, Second Military Medical University, Shanghai 200003, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2006 Jun 13;86(22):1516-21.

Abstract

OBJECTIVE

To study the genetic heterogeneity of autosomal dominant polycystic kidney disease by linkage analysis with microsatellite DNA tightly linked to PKD1 and PKD2 in Shanghai Han nationality population and to compare the clinical presentation of ADPKD type 1 and 2.

METHODS

43 unrelated ADPKD families were included in this study after informed consent was obtained. Families were typed by using microsatellites for PKD1 and PKD2. Microsatellite DNA were amplified by polymerase chain reaction and studied by linkage analysis. The clinical history, symptoms, complications and records of ultrasound examination of patients of ADPKD type 1 and 2 were collected. The data were analyzed by medical statistics.

RESULTS

In total families, 36 families showed to be linked to PKD1, which accounts to 84% of all families. 7 families linked to PKD2, which accounts to 16%. The diagnosis age of patients of ADPKD type 1 and type 2 is 36.8 year and 46.3 year, the frequency and diagnosis age of hypertension is 62%, 54% and 37.4 year, 49.1 year, and the frequency of hepatic cysts, urinary-tract infection, macrohematuria, urinary-tract calculi, cerebrovascular accident is 59% and 60%, 20% and 26%, 33% and 20%, 24% and 14%, 13% and 7%, respectively, the onset age of ESRD is 51.2 year and 64.7 year.

CONCLUSION

The results in this study were similar to the ones of foreign reports. There is no significant difference of frequencies of complications between the patients of two types. But the diagnosis age of ADPKD and hypertension, the onset age of ESRD of patients of type 1 are earlier than that of type 2, which suggests that the prognosis of patients of type 2 is better than that of type 1.

摘要

目的

通过与多囊肾病1(PKD1)和多囊肾病2(PKD2)紧密连锁的微卫星DNA进行连锁分析,研究上海汉族人群常染色体显性遗传性多囊肾病的遗传异质性,并比较1型和2型常染色体显性遗传性多囊肾病(ADPKD)的临床表现。

方法

在获得知情同意后,本研究纳入了43个无亲缘关系的ADPKD家庭。使用针对PKD1和PKD2的微卫星对家庭进行分型。通过聚合酶链反应扩增微卫星DNA,并进行连锁分析。收集1型和2型ADPKD患者的临床病史、症状、并发症及超声检查记录。采用医学统计学方法对数据进行分析。

结果

在所有家庭中,36个家庭显示与PKD1连锁,占所有家庭的84%。7个家庭与PKD2连锁,占16%。1型和2型ADPKD患者的诊断年龄分别为36.8岁和46.3岁,高血压的发生率及诊断年龄分别为62%、54%和37.4岁、49.1岁,肝囊肿、尿路感染、肉眼血尿、尿路结石、脑血管意外的发生率分别为59%和60%、20%和26%、33%和20%、24%和14%、13%和7%,终末期肾病(ESRD)的发病年龄分别为51.2岁和64.7岁。

结论

本研究结果与国外报道相似。两种类型患者并发症的发生率无显著差异。但1型ADPKD患者的诊断年龄及高血压发病年龄、ESRD发病年龄均早于2型患者,提示2型患者的预后优于1型患者。

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