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新生儿听力障碍基因筛查:一项基于人群的纵向研究。

Newborn genetic screening for hearing impairment: a population-based longitudinal study.

作者信息

Wu Chen-Chi, Tsai Ching-Hui, Hung Chia-Cheng, Lin Yin-Hung, Lin Yi-Hsin, Huang Fang-Li, Tsao Po-Nien, Su Yi-Ning, Lee Yungling Leo, Hsieh Wu-Shiun, Hsu Chuan-Jen

机构信息

Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan.

Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan.

出版信息

Genet Med. 2017 Jan;19(1):6-12. doi: 10.1038/gim.2016.66. Epub 2016 Jun 16.

Abstract

PURPOSE

The feasibility of genetic screening for deafness-causing mutations in newborns has been reported in several studies. The aim of this study was to investigate the long-term results in those who screened positive for deafness mutations; these results are crucial to determine the cost-effectiveness to justify population-wide genetic screening.

METHODS

We performed simultaneous hearing screening and genetic screening targeting four common deafness mutations (p.V37I and c.235delC of GJB2, c.919-2A>G of SLC26A4, and the mitochondrial m.1555A>G) in 5173 newborns at a tertiary hospital between 2009 and 2015. Serial audiometric results up to 6 years old were then analyzed in children with conclusive genotypes.

RESULTS

Newborn genetic screening identified 82 (1.6%) babies with conclusive genotypes, comprising 62 (1.2%) with GJB2 p.V37I/p.V37I, 16 (0.3%) with GJB2 p.V37I/c.235delC, and 4 (0.1%) with m.1555A>G. Of these, 46 (56.1%) passed hearing screening at birth. Long-term follow-up demonstrated progressive hearing loss in children with the GJB2 p.V37I/p.V37I and p.V37I/c.235delC genotypes; this hearing loss deteriorated by approximately 1 decibel hearing level (dBHL) per year.

CONCLUSIONS

We delineated the longitudinal auditory features of the highly prevalent GJB2 p.V37I mutation on a general population basis and confirmed the utility of newborn genetic screening in identifying infants with late-onset or progressive hearing impairment undetectable by newborn hearing screening.Genet Med 19 1, 6-12.

摘要

目的

多项研究报道了对新生儿进行致聋突变基因筛查的可行性。本研究旨在调查耳聋突变筛查呈阳性者的长期结果;这些结果对于确定全人群基因筛查的成本效益以证明其合理性至关重要。

方法

2009年至2015年期间,我们在一家三级医院对5173名新生儿同时进行听力筛查和针对四种常见耳聋突变(GJB2基因的p.V37I和c.235delC、SLC26A4基因的c.919-2A>G以及线粒体m.1555A>G)的基因筛查。随后对具有明确基因型的儿童直至6岁的系列听力测试结果进行分析。

结果

新生儿基因筛查确定了82名(1.6%)具有明确基因型的婴儿,其中62名(1.2%)为GJB2基因p.V37I/p.V37I,16名(0.3%)为GJB2基因p.V37I/c.235delC,4名(0.1%)为m.1555A>G。其中,46名(56.1%)在出生时通过了听力筛查。长期随访显示,具有GJB2基因p.V37I/p.V37I和p.V37I/c.235delC基因型的儿童出现进行性听力损失;这种听力损失每年大约恶化1分贝听力水平(dBHL)。

结论

我们在一般人群基础上描绘了高度流行的GJB2基因p.V37I突变的纵向听觉特征,并证实了新生儿基因筛查在识别新生儿听力筛查无法检测到的迟发性或进行性听力障碍婴儿方面的效用。《遗传医学》19卷1期,6 - 12页。

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