Zheng Jinxian, Han Shuai, Ye Wen, Yao Shulie, Qi Ming, Chen Jianfen, Xu Hong
Hangzhou Health Service Center for Children and Women, Hangzhou, Zhejiang 310006, China.
Zhonghua Yi Xue Yi Chuan Xue Za Zhi. 2021 May 10;38(5):485-487. doi: 10.3760/cma.j.cn511374-20200331-00223.
To establish a screening model for females of reproductive age carrying Duchenne muscular dystrophy (DMD) variants based on a current community health examination platform.
A total of 61 870 participants were recruited between October 2017 and October 2019. Serum creatine kinase (CK) was measured with a Roche Cobasc 701/702 using an enzymatic rate method. Genetic testing was offered to those with a CK level of ≥ 200 U/L. For carriers of DMD variants, genetic counseling and follow up were provided.
For the 61 870 females participating in the program, 1078 were found with raised serum CK (≥ 200 U/L), of which 618 (57.33%) accepted CK re-measurement after at least a two-week interval. One hundred and twenty cases were found with sustained serum CK elevation, of which 6 were confirmed to be definite DMD carriers regardless of family history. Genetic testing was provided to 33 females with a family history for DMD, and 13 were determined as definite carriers. An affected fetus was detected by prenatal diagnosis. After genetic counseling, the parents had opted induced abortion.
Large-scale DMD carrier screening through a three-step approach based on the current community health examination platform is both feasible and cost effective.
基于当前社区健康检查平台建立育龄期携带杜氏肌营养不良症(DMD)变异的女性筛查模型。
2017年10月至2019年10月共招募了61870名参与者。使用罗氏Cobasc 701/702通过酶速率法测量血清肌酸激酶(CK)。为CK水平≥200 U/L的参与者提供基因检测。对于DMD变异携带者,提供遗传咨询和随访。
在参与该项目的61870名女性中,发现1078名血清CK升高(≥200 U/L),其中618名(57.33%)在至少间隔两周后接受了CK复测。发现120例血清CK持续升高,其中6例被确诊为明确的DMD携带者,无论家族史如何。为33名有DMD家族史的女性提供了基因检测,其中13名被确定为明确的携带者。通过产前诊断检测到一名受影响的胎儿。经过遗传咨询后,父母选择了人工流产。
基于当前社区健康检查平台通过三步法进行大规模DMD携带者筛查既可行又具有成本效益。