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对表现出特征性体征和症状的神经代谢疾病患者的诊疗方法。

Approach to Patients with Neurometabolic Diseases Who Show Characteristic Signs and Symptoms.

作者信息

Karimzadeh Parvaneh, Ghofrani Mohammad, Nasiri Shahram

机构信息

Department of Pediatric Neurology, Pediatric Neurology Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Pediatric Neurology Department, Mofid Children's Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Iran J Child Neurol. 2020 Summer;14(3):19-32.

Abstract

Neurometabolic disorders are hereditary conditions mainly affect the function of the brain and the nervous system. The prevalence of these disorders is 1 in 1,000 live births. Such disorders, at different ages, could manifest as sepsis, hypoglycemia, and other neurologic disorders. Having similar manifestations leads to delayed diagnosis of neurometabolic disorders. A number of neurometabolic disorders have known treatments; however, to prevent long-term complications the key factors are early diagnosis and treatment. Although a large number of neurometabolic diseases have no treatment or cure, the correct and on-time diagnosis before death is important for parents to have plans for prenatal diagnosis. Different diagnostic procedures could be offered to parents, enzymatic procedures, and determining metabolites in plasma, urine, and CSF, and molecular genetic diagnosis. Molecular genetic diagnostic procedures are expensive and could not be offered to all parents. Therefore, we aimed to design algorithms to diagnose neurometabolic disorders according to some frequent and characteristic signs and symptoms. By designing these algorithms and using them properly, we could offer diagnostic enzymatic panels. These enzymatic panels are inexpensive; thereby reducing the financial burden on the parents. Also, having an early diagnosis according to these panels could lead to offering more accurate and less expensive molecular genetic tests.

摘要

神经代谢紊乱是主要影响大脑和神经系统功能的遗传性疾病。这些疾病的患病率为每1000例活产中有1例。此类疾病在不同年龄段可能表现为败血症、低血糖和其他神经系统疾病。相似的表现导致神经代谢紊乱的诊断延迟。许多神经代谢紊乱有已知的治疗方法;然而,为预防长期并发症,关键因素是早期诊断和治疗。尽管大量神经代谢疾病无法治疗或治愈,但在死亡前正确且及时的诊断对于父母进行产前诊断计划很重要。可以向父母提供不同的诊断程序,如酶学程序、测定血浆、尿液和脑脊液中的代谢物以及分子遗传学诊断。分子遗传学诊断程序昂贵,无法提供给所有父母。因此,我们旨在根据一些常见且具有特征性的体征和症状设计诊断神经代谢紊乱的算法。通过设计并正确使用这些算法,我们可以提供诊断酶学检测组合。这些酶学检测组合价格低廉,从而减轻父母的经济负担。此外,根据这些检测组合进行早期诊断可以带来更准确且成本更低的分子遗传学检测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b826/7468080/97ebd8b1afc8/ijcn-14-019-g001.jpg

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