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杜氏或贝克型肌营养不良症的基因分析与产前诊断

[Genetic analysis and prenatal diagnosis of Duchenne or Becker muscular dystrophy].

作者信息

Zhao W, Jiang N, Li S, Li J S, Miao Y, Liang S Y, Yu D Y

机构信息

Genetic Testing Center, Qingdao Women and Children's Hospital, Qingdao 266034, China.

出版信息

Zhonghua Fu Chan Ke Za Zhi. 2019 Apr 25;54(4):226-231. doi: 10.3760/cma.j.issn.0529-567x.2019.04.003.

Abstract

To explore the mutation characteristics of DMD gene in patients with Duchenne or Becker muscular dystrophy and female carriers, to provide effective prenatal diagnosis. Samples were collected from 94 male patients clinically diagnosed with Duchenne or Becker muscular dystrophy and 121 corresponding female relatives from Qingdao Women and Childrens Hospital from June 2011 to October 2018. Multiplex ligation-dependent probe amplification (MLPA) was used to detect their DMD gene, and 23 high risk pregnants were performed prenatal diagnosis. Any candidate of DMD gene single-exon deletion was validated by further PCR amplification. The sample with whole DMD gene deletion was confirmed by chromosomal microarray analysis (CMA) to detect copy number variations and break site. Among 94 clinical Duchenne or Becker muscular dystrophy patients, 66(70.2%, 66/94) were detected gene mutation; 56 cases were exon deletion mutation and 10 cases were duplication mutation. In 121 female relatives, 48 cases (39.7%, 48/121) were diagnosed as carriers. The mutation carrying rate, was 64.5% (40/62) identified in 62 mothers of Duchenne or Becker muscular dystrophy patients. Five Duchenne or Becker muscular dystrophy fetuses and 5 carrier fetuses were prenatally diagnosed in 23 high risk pregnants. Two children with the entire DMD gene deletion were identified more deletions at Xp21, with deletions of 6.66 Mb and 10.64 Mb respectively. MLPA may be an important method to detect DMD gene mutation of deletion and duplication. Therefore, the diagnosis of probands, female carriers and making an effective prenatal diagnosis are essential to reduce the birth of children with Duchenne or Becker muscular dystrophy.

摘要

为探讨杜氏或贝克型肌营养不良患者及女性携带者中DMD基因的突变特征,以提供有效的产前诊断。2011年6月至2018年10月,从青岛妇女儿童医院收集了94例临床诊断为杜氏或贝克型肌营养不良的男性患者及121名相应的女性亲属样本。采用多重连接依赖探针扩增技术(MLPA)检测其DMD基因,并对23例高危孕妇进行产前诊断。对任何DMD基因单外显子缺失的候选者通过进一步的PCR扩增进行验证。对全DMD基因缺失的样本通过染色体微阵列分析(CMA)检测拷贝数变异及断裂位点。94例临床诊断为杜氏或贝克型肌营养不良的患者中,66例(70.2%,66/94)检测到基因突变;56例为外显子缺失突变,10例为重复突变。121名女性亲属中,48例(39.7%,48/121)被诊断为携带者。在62例杜氏或贝克型肌营养不良患者的母亲中,携带突变率为64.5%(40/62)。23例高危孕妇中,产前诊断出5例杜氏或贝克型肌营养不良胎儿及5例携带者胎儿。2例全DMD基因缺失的患儿在Xp21区域检测到更多缺失,分别缺失6.66 Mb和10.64 Mb。MLPA可能是检测DMD基因缺失和重复突变的重要方法。因此,对先证者、女性携带者进行诊断并进行有效的产前诊断对于减少杜氏或贝克型肌营养不良患儿的出生至关重要。

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