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神经管缺陷的临床谱,特别参考染色体核型分析研究

Clinical spectrum of neural tube defects with special reference to karyotyping study.

作者信息

Kumar Vijayendra, Singh Anutosh, Sharma Shiv Prasad, Srivastava Arvind, Saxena Ajit, Gangopadhyay Ajay Narayan

机构信息

Department of Pediatric Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.

出版信息

J Pediatr Neurosci. 2012 May;7(2):82-4. doi: 10.4103/1817-1745.102560.

Abstract

BACKGROUND

Neural tube defects are common congenital malformations of the central nervous system. Despite years of intensive epidemiological, clinical, and experimental research, the exact etiology of NTD remains rather complex and poorly understood. The present study attempted to look into the association of occurrence of NTD with reference to folic acid levels, along with karyotyping status.

MATERIALS AND METHODS

Detailed history was taken with emphasis on age of the baby and mother, parity, antenatal folic acid intake. Five milliliters of blood was drawn from all the babies and their mothers and divided equally in preheparinized vials (for karyotyping) and plain vials (for folic acid estimation). The total duration was 2 years.

RESULTS

The total number (n) in the study group was 75. The folic acid level was less in affected babies and their mother when compared to matched controls. Chromosomal defect was observed in nine of the 75 patients. Karyotyping defects were higher in children born to mothers of the age group 31-40 years and when their birth order was second.

CONCLUSION

Folic acid supplementation needs to be continued to prevent the occurrence of NTD, and the perinatal identification of NTD should alert one to the possibility of chromosomal abnormalities and prompt a thorough cytogenetic investigation and genetic counseling.

摘要

背景

神经管缺陷是常见的中枢神经系统先天性畸形。尽管经过多年深入的流行病学、临床和实验研究,但神经管缺陷的确切病因仍然相当复杂且了解甚少。本研究试图探讨神经管缺陷的发生与叶酸水平以及核型分析状态之间的关联。

材料与方法

详细记录病史,重点关注婴儿和母亲的年龄、产次、产前叶酸摄入量。从所有婴儿及其母亲身上抽取5毫升血液,平均分为预肝素化小瓶(用于核型分析)和平小瓶(用于叶酸测定)。总时长为2年。

结果

研究组总数(n)为75例。与匹配的对照组相比,患病婴儿及其母亲的叶酸水平较低。75例患者中有9例观察到染色体缺陷。31至40岁年龄组母亲所生的孩子以及出生顺序为第二胎的孩子中,核型分析缺陷较高。

结论

需要持续补充叶酸以预防神经管缺陷的发生,围产期对神经管缺陷的识别应提醒人们注意染色体异常的可能性,并促使进行全面的细胞遗传学检查和遗传咨询。

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本文引用的文献

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Aneuploidy among prenatally detected neural tube defects.
Am J Med Genet. 1996 Jan 11;61(2):171-3. doi: 10.1002/(SICI)1096-8628(19960111)61:2<171::AID-AJMG14>3.0.CO;2-R.
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Evidence for multi-site closure of the neural tube in humans.人类神经管多部位闭合的证据。
Am J Med Genet. 1993 Oct 1;47(5):723-43. doi: 10.1002/ajmg.1320470528.

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