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单基因疾病的产前和胚胎植入前遗传学诊断:1977 年至 2016 年的一项基于人群的研究。

Prenatal and preimplantation genetic diagnosis for single gene disorders: A population-based study from 1977 to 2016.

机构信息

Public Health Genetics, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.

Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia.

出版信息

Prenat Diagn. 2018 Nov;38(12):904-910. doi: 10.1002/pd.5352. Epub 2018 Sep 24.

Abstract

OBJECTIVE

To examine the statewide utilisation of prenatal diagnosis (PNDx) and preimplantation genetic diagnosis (PGT-M) for single gene disorders.

METHODS

Population-based study of all women utilising PNDx in the Australian state of Victoria from 1977 to 2016. Single gene disorders were categorised using a systematic approach that aimed to reflect aspects of the PNDx decision-making process. Data on PGT-M for single gene disorders from 2005 to 2016 were similarly examined for comparison. Statistical significance testing was performed with χ test.

RESULTS

Following an initial uptake period, annual PNDx rates for single gene disorders stabilised between 1.3 and 2.2 per 1000 births after the year 2000. The majority of PNDx (72%) was performed for disorders that primarily impair physical ability, while PNDx for adult onset conditions was rare (3%). PGT-M for single gene disorders has seen rapid growth since its introduction, and annual numbers now equal that of PNDx. In contrast to PNDx, one quarter of PGT-M tests were performed for adult onset conditions.

CONCLUSIONS

Our population-wide analysis has demonstrated a steady demand for PNDx for single gene disorders over the past decade, in contrast to the rapidly increasing utilisation of PGT-M. PGT-M appears to be the preferred testing modality for adult onset disorders.

摘要

目的

研究单基因疾病在澳大利亚维多利亚州的产前诊断(PNDx)和植入前遗传学诊断(PGT-M)的全州利用情况。

方法

对 1977 年至 2016 年期间澳大利亚维多利亚州所有利用 PNDx 的女性进行基于人群的研究。采用系统的方法对单基因疾病进行分类,旨在反映 PNDx 决策过程的各个方面。同样对 2005 年至 2016 年期间单基因疾病的 PGT-M 数据进行了比较分析。采用 χ 检验进行统计学显著性检验。

结果

在初始采用期之后,2000 年以后,单基因疾病的年度 PNDx 率稳定在每 1000 例活产 1.3 至 2.2 例之间。大多数 PNDx(72%)是针对主要损害身体能力的疾病进行的,而针对成人发病疾病的 PNDx 则很少见(3%)。PGT-M 自引入以来呈快速增长趋势,年检测数量现已与 PNDx 相当。与 PNDx 不同,四分之一的 PGT-M 检测是针对成人发病疾病进行的。

结论

我们的全人群分析表明,过去十年中,单基因疾病的 PNDx 需求稳定,而 PGT-M 的利用率迅速增加。PGT-M 似乎是成人发病疾病的首选检测方式。

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