目的:探讨腓骨肌萎缩症1型(CMT1)儿童的肌电图和遗传学特点。方法:对24例CMT1型患儿进行常规肌电图检测,同时联合应用PCR-双酶切分析检测17p11.2-12上的基因重复,对照组为10名健康儿童。结果:24例患儿运动或感觉神经传导速度存在不同程度的减慢或消失,且感觉神经病变重于运动神经,下肢受累程度重于上肢。所检24例患儿72块肌肉中,40块呈神经源性损害(56%);患儿年龄越大,肌肉受累程度越严重。24例患儿中,PCR-双酶切法在13例患儿中检测出1760 bp片段,占54%。正常对照组未检测到此片段。结论:CMT1患儿肌电图改变特征明显,以周围神经传导速度减慢为主,肌肉病变多呈神经源性损害。PCR-双酶切可作为一种简单有效的CMT1型基因诊断方法。
Abstract
OBJECTIVE: To study the electromyographic and genetic characteristics in children with Charcot-Marie-Tooth disease type 1 (CMT1). METHODS: Routine electromyography and nerve conduction were performed in 24 children with CMT1. Polymerase chain reaction (PCR) combined with restriction enzyme digestion was used to detect gene duplication on chromosome 17p11.2-12. Ten healthy children served as the control group. RESULTS: The peripheral nerve conduction velocity slowed or disappeared in all of the 24 patients (100%). The lesions of the sensory nerves were more severe than the motor nerves, and the lesions of the lower limbs were more severe than the upper limbs. Of 72 muscles detected, 40 (56%) showed neurogenic lesions. The older the patients, the more severe the muscle lesions. Specific junction fragments (1760 bp) were identified in 13 (54%) out of 24 patients, but were not identified in the healthy controls. CONCLUSIONS: The electromyographic changes are characterized by peripheral nerve conduction velocities slowing and neurogenic lesions of muscles in children with CMT1. The PCR combined with restriction enzyme digestion may be a simple and accurate method for gene diagnosis of CMT1.
关键词
腓骨肌萎缩症1型 /
肌电图 /
儿童
Key words
Charcot-Marie-Tooth disease type 1 /
Electromyography /
Child
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1]Berger P, Young P, Suter U. Molecular cell biology of Charcot-Marie-Tooth disease[J] Neurogenetics, 2002, 4(1): 1-15.
[2]张如旭,郭鹏,任志军,赵国华,刘三妹,刘婷,等.LITAF、RAB7、LMNA和MTMR2基因在中国人腓骨肌萎缩症患者的突变分析[J].遗传,2010,32(8):817-823.
[3]Hisama FM. Familial periodic paralysis and Charcot-Marie-Tooth disease in a 7-generation family[J]. Arch Neurol, 2005, 62(1): 135-138.
[4]刘维亮,李芳,麻宏伟,李海燕. 中国人脊髓性肌萎缩症患儿的SMN基因学研究[J].中国当代儿科杂志,2010,12(7):539-543.
[5]邹艺,刘英,李素荣,胥勋成,高国勋. 腓骨肌萎缩症的临床及神经电生理特点分析[J].临床神经电生理学杂志,2008,17(5):268-270.
[6]郭鹏,唐北沙,赵国华,刘小民,张付峰,张如旭,等. 腓骨肌萎缩症的病理学特点和基因突变[J]. 中华医学杂志,2005,85(34):2382-2385.
[7]Zamurovi'c N, Mili'c V, Dackovi'c J, Zamurovi'c D, Culjkovi'c B, Parlovi'c S, et al. Analysisi of mutation in the chromosome 17p11.2 region in patients with Charcot-Marie-Tooth type 1 disease and in patients with tomaculos neurpathy[J]. Srp Arh Celok Lek, 2002, 130(3-4): 59-63.