Lancet Neurol:青年亨廷顿舞蹈症患者疾病生理及临床特征

2018-09-21 zhangfan MedSci原创

研究认为,青年CAG重复序列高度扩展亨廷顿患者的疾病特征与低度扩展人群和成年患者存在较大差异,重新区分亨廷顿病亚型十分必要

亨廷顿是一种由亨廷顿基因CAG扩展重复序列突变导致的罕见神经退行性疾病。相比于成年患者,对于20岁以下青年患者疾病特征研究尚不充分。近日研究人员就青年亨廷顿患者CAG序列特征对疾病表现、进展和生存的影响进行了考察。

研究人员分析了青年亨廷顿患者CAG重复序列的长度与其神经症状以及运动障碍之间的关系,并比较了其与30-60岁患者或超过40个以上重复序列患者病情的差异。根据突变程度将患者分为高度(HE)或低度扩增亚组(LE)。

总计提取了580名患者资料,其中青年患者36人,成年患者197人符合要求。根据护理人员的报告,HE亚组患者步态障碍为第一症状的比例较高(80% vs 27%),而手部灵活性下降在LE亚组中更早出现(42% vs 0)。相比于LE亚组,青年HE亚组患者发育迟缓(90% vs 0)、严重步态障碍(90% vs 35%)和癫痫(80% vs 11%)发生率较高。青年亨廷顿患者的疾病进展快于成年患者。121名死亡患者中,青年患者死亡17例,成年患者死亡104例,死亡风险为2.18。

研究认为,青年CAG重复序列高度扩展亨廷顿患者的疾病特征与低度扩展人群和成年患者存在较大差异,重新区分亨廷顿病亚型十分必要。

原始出处:

Caterina Fusilli et al. Biological and clinical manifestations of juvenile Huntington's disease: a retrospective analysis. Lancet Neurol. September 19 2018.

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    2019-05-11 howi
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    2019-09-06 yinhl1978
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