基础医学与临床 ›› 2017, Vol. 37 ›› Issue (11): 1601-1606.

• 研究论文 • 上一篇    下一篇

64例Gitelman综合征患者临床表现和基因突变分析

王芬1,崔云英2,李春艳1,童安莉3,李玉秀4   

  1. 1. 北京协和医院
    2. 中国医学科学院北京协和医院内分泌科卫生部内分泌重点实验室
    3. 中国医学科学院北京协和医学院北京协和医院内分泌科 卫生部内分泌重点实验室
    4. 中国医学科学院北京协和医学院北京协和医院内分泌科
  • 收稿日期:2017-02-28 修回日期:2017-09-06 出版日期:2017-11-05 发布日期:2017-11-01
  • 通讯作者: 童安莉 E-mail:tonganli@hotmail.com

Clinical character and genetic mutation of 64 patients with Gitelman syndrome

  • Received:2017-02-28 Revised:2017-09-06 Online:2017-11-05 Published:2017-11-01
  • Contact: TONG An-li E-mail:tonganli@hotmail.com

摘要: 目的 总结Gitelman综合征的临床及基因特点,以提高临床对Gitelman综合征的认识和诊治。方法 回顾性分析了北京协和医院2012至2016年诊断的64例Gitelman综合征患者的临床和基因特点。结果 64例患者中男性患者39例,女性患者25例。初诊时年龄(35±14)岁,血钾(2.86±0.44)mmol/L,同步24 h尿钾(82.27 ± 39.73)mmol/d, 血镁(0.62±0.14)mmol/L,24 h尿钙(0.94±0.83)mmol/d,平均血压为110/69 mmHg。64例患者的基因突变散在分布于SLC12A3基因,40例患者为复合杂合突变,10例患者为单杂合突变,9例患者为多杂合突变,5例患者为纯合突变;复合杂合突变者初诊时血钾水平较高(P<0.05)。64例患者共检出74种不同的突变类型,32%的位点为新发突变(24/74)。p.Asp486Asn是最常见的突变位点,见于25%(16/64)的患者。结论 Gitelman综合征患者的基因突变和临床表现异质性很大,复合杂合突变患者的临床表现相对较轻。p.Asp486Asn是本研究中的热点突变。

关键词: Gitelman综合征, 基因型, 表型

Abstract: Objective To study the clinical and genetic profile of the patients with Gitelman syndrome (GS). Method We retrospectively analyzed the genotype and phenotype of 64 GS patients diagnosed in Peking Union Medical Hospital from 2012 to 2016. Results The age at diagnosis of these 64 patients (39 male,25 female) were 35±14 years. At admission, the serum potassium level of the patients was 2.86±0.44mmol/L, serum magnesium level was 0.62±0.14mmol/L, 24-hour urine potassium was 82.27 ± 39.73mmol/d, 24-hour urine calcium was 0.94±0.83mmol/d and their average blood pressure was 110/69mmHg. The genotype was divided into four groups including homozygous (N=5), compound heterozygous (N=40), multiple mutations (N=9) and single heterozygous mutation (N=10) group. The compound heterozygous group had higher serum potassium concentration (P<0.05) and the homozygous group had a relatively higher serum magnesium concentration but without significance. A total of 74 distinctly different mutation alleles were identified, of which 24 were new mutation alleles. p.Asp486Asn was a hotspot in our series which was found in 16 patients (25.0%). Conclusions There exists great heterogeneity of genotype and phenotype in Gitelman syndrome. Patients with compound heterozygous have a relatively milder phenotype. p.Asp486Asn mutation is a hotspot in Chinese patients.

Key words: Gitelman syndrome, Genotype, Pheonotype

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