载脂蛋白E基因型对肝豆状核变性发病年龄的影响

肝豆状核变性(hepatolenticulardegeneration,HLD)是一种神经科较为常见的单基因常染色体隐性遗传病,其致病基因ATP7B基因已被定位于13q14.3区,中国患者的突变热区为该基因8号外显子第778密码子(Arg778Leu)。近年来,许多学者对此种突变型与HLD临床表现间的相关性进行了深入的研     

变性高效液相色谱在检测肝豆状核变性基因突变中的作用

目的　建立变性高效液相色谱 (denaturinghighperformanceliquidchromatography,DHPLC)技术检测肝豆状核变性 (WD)基因第 8外显子突变。方法　利用聚合酶链式反应 (PCR)扩增WD基因第 8外显子片段 ,扩增产物直接进行DHPLC分析 ;对峰型有改变的样品经测序分析确认突变。结果　在 5 1例WD先证者中共发现两种错义突变 (Arg778Leu和Arg778Gln)、一种插入突变 (Ins2 30 2C)和一种多态性位点 (C2 310G)。其中 12例先证者带有Arg778Leu杂合错义突变 ,3例为Arg778Leu纯合错义突变 ,1例为Arg778Gln杂合错义突变 ,1例为杂合 2 30 2C插入突变。多态位点C2 310G与Arg778Leu突变完全连锁。结论　WD基因第 8外显子阳性检出率为 33 3% (17/ 5 1) ,说明DHPLC技术是一种可用于临床WD基因诊断的高效、灵敏和操作简便的方法     

肝豆状核变性患者ATP7B基因8、12号外显子突变的DNA分析

目的 对肝豆状核变性(Wilson disease,WD)ATP7B基因的外显子8、12进行DNA测序分析并建立直接基因诊断方法.方法 102例WD患者和82例对照正常人提取基因组DNA,PCR扩增ATP7B第8、12号外显子,8号外显子及12号外显子扩增产物分别行Msp Ⅰ及Tail内切酶酶切分析;后对所有患者及对照组DNA外显子扩增产物行直接测序.结果 102例WD患者,8号外显子35例存在Msp Ⅰ酶切反应异常,测序示Arg778Leu纯合或杂合突变(占34.31%),其中12例伴Leu770Leu多态性;12号外显子13例存在Tail酶切反应异常,测序示Thr935Met杂合错义突变(占12.75%),1例存在Argg19Gly杂合错义突变,Arg952Lys在患者及对照组中均检出.结论ATPTB基因外显子8、12为WD突变热点,其中8号外显子以Arg778Leu、12号外显子以Thr935Met为主要突变形式,临床上可用PCR-Msp Ⅰ酶切、PCR-Tail酶切反应作为WD患者初步筛选方法.     

结节性硬化症伴癫痫发作患者基因突变类型与临床表型相关性研究

目的探讨结节性硬化症伴癫痫发作患者的基因突变类型与临床表型的关系。方法对2013年10月至2019年10月在广东三九脑科医院确诊的结节性硬化症伴癫痫发作患者进行TSC基因检测,对基因阳性者进行基因突变类型分型,并收集其临床资料,从而探讨不同基因突变类型与临床表型的关系。结果共85例患者TSC基因检测阳性,其中TSC1基因突变34例(40.0%)分别为:剪切突变4例(11.8%)、移码突变10例(29.4%)、无义突变4例(11.8%)及错义突变16例(47.0%)。TSC2基因突变51例(60.0%)分别为:剪切突变3例(5.9%)、移码突变19例(37.3%)、无义突变1例(1.9%)、错义突变25例(49.0%)及大片段缺失3例(5.9%)。突变类型均以移码突变及错义突变的突变率较高。对起病年龄进行分层,分为≤1岁、～3岁、～6岁、～18岁、18岁,发现不同起病年龄在TSC1及TSC2基因中有统计学差异(P 0.05)。同时发现肾脏病变及智力低下的发生率在TSC1及TSC2基因中有统计学意义(分别P 0.05)。此外,根据基因突变类型进行分组,分为移码突变组、错义突变组及其他突变(包括剪切突变、无义突变及大片段缺失)组,发现心脏病变的发生率在不同基因突变类型中有统计学差异(分别P 0.05)。结论 TSC1及TSC2基因突变类型及临床表型多样,TSC2起病年龄更小,更容易出现肾脏病变及智力低下。错义突变更易发生心脏病变。基因类型-临床表型的研究可对TSC患者的疾病发展及预后做出初步评估。     

肝豆状核变性基因Arg778Leu突变与临床表现关系研究

目的 探讨肝豆状核变性（Ｗｉｌｓｏｎ ｄｉｓｅａｓｅ,ＷＤ）基因的突变热点Ａｒｇ７７８Ｌｅｕ与临床表现的关系。方法 采用荧光ＰＣＲ检测６６例ＷＤ患者和３０例对照患者的ＷＤ基因８号外显子Ａｒｇ７７８Ｌｅｕ突变,把６６例ＷＤ病人分为突变组和无突变组与临床资料（包括性别、发病年龄、首发症状、血清铜、铜蓝蛋白、２４ｈ尿铜等）进行相关分析。结果 在６６例ＷＤ患者中检出５例突变纯合子和２１例突变杂合子,其余４０例无该突变;３０例对照患者均无该点突变。突变组的平均发病年龄为１８．５８岁,无突变组平均发病年龄为１４．６１岁,差异有显著意义（Ｐ＝０．０３）。患者性别,以神经系统或消化系统表现为首发症状,血清铜、铜蓝蛋白及２４ｈ尿铜水平与该突变均无显著相关性（Ｐ〉０．０５）。结论 Ａｒｇ７７８Ｌｅｕ突变与发病年龄有关,该突变使ＷＤ     

β2肾上腺素能受体基因多态性与早发重症肌无力关系研究

目的探讨β2肾上腺素能受体(β2 adrenergic receptor,β2-AR)16位点基因多态性与不同临床表型的早发重症肌无力(myasthenia gravis,MG)的关系。方法 105例MG患者,其中起病年龄≤40岁的早发MG为48例。根据胸腺影像将早发MG患者分为胸腺正常组(13例)、胸腺增生组(22例)和胸腺瘤组(7例),未知6例。根据性别分为女性组(31例)和男性组(17例),根据首发症状分为OMG组(29例)和GMG组(19例),根据伴发其他自身免疫疾病情况分为伴发(10例)和不伴发(33例)其他自身免疫性疾病组,未知5例。PCR产物直接测序方法检测相对应的两组间β2-AR基因16位点多态性分布差异。结果胸腺正常的早发MG患者16位点基因型以Arg/Arg(53.8%)为主,胸腺增生以Arg/Arg(54.6%)为主,胸腺瘤以Arg/Gly(71.4%)为主,3组间3种基因型分布差异无统计学意义(χ2=5.657,P=0.226)。女性早发MG患者16位点基因型以Arg/Arg(58.1%)为主,男性早发MG患者以Arg/Gly(58.8%)为主,组间差异有统计学意义(χ2=6.064,P=0.048)。首发OMG组以Arg/Arg(48.3%)基因型为主,GMG组Arg/Arg(42.1%)和Arg/Gly(47.4%)比例相似,组间差异无统计学意义(χ2=1.623,P=0.444)。伴发其他自身免疫性疾病组以Arg/Arg(80.0%)为主,不伴发组以Arg/Gly(39.4%)为主,组间差异有统计学意义(χ2=6.394,P=0.041)。结论β2-AR基因16位点基因多态性与不同性别的早发型MG相关;与伴发其他自身免疫性疾病的早发型MG相关。     

中国华东地区家族性肌萎缩侧索硬化症患者SOD1基因突变检测及临床特点分析

目的对中国华东地区26例临床确诊为家族性肌萎缩侧索硬化症(FALS)家系的先证者进行铜锌超氧化物歧化酶(SOD1)的基因突变筛查。方法收集26例FALS家系先证者的外周血样本及临床资料。采用PCR技术结合DNA直接测序法对外周血DNA进行SOD1基因5个外显子的突变筛查,并分析SOD1基因突变与临床表型的关系。结果有6例先证者检测出3种SOD1突变。其中3例为位于2号外显子的已知错义突变p.His46Arg(c.140AG),均表现为单侧下肢远端起病,上运动神经元损害不明显,平均病程可达10年以上。2例为位于2号外显子的已知错义突变p.Val47Ala(c.143TC),临床表型较复杂,病变进展相对较快。1例为位于2号外显子新的错义突变p.Gly37Arg(c.112GC),单侧上肢远端起病,上下运动神经元均受损,进展缓慢。结论中国华东地区FALS患者中SOD1基因突变仍占首位,突变与临床表型相关,其中His46Arg的临床表型具有特征性,有助于疾病预后判断。     

对氧磷酶1基因Gln192Arg多态性与帕金森病的相关性

目的探讨中国汉族人群中对氧磷酶1(PON1)基因Gln192Arg单核苷酸多态性(SNP)与帕金森病(PD)的关系。方法采用等位基因特异性聚合酶链反应(A-S PCR)技术检测186例PD患者和228名健康对照PON1基因Gln192Arg位点SNP的分布,分析各基因型与患者发病年龄和疾病严重程度的关系。结果 PD组和对照组间基因型频率和等位基因频率比较差异均无统计学意义(χ2=0.56,P=0.76;χ2=0.06,P=0.81)。进一步按性别分层分析,两组相同性别间基因型和等位基因频率比较亦未发现有统计学差异存在(P>0.05)。PD患者各基因型与发病年龄和疾病严重程度亦无相关性。结论中国汉族人群中PON1基因Gln192Arg位点SNP与PD无相关性。     

肝豆状核变性患者ATP7B基因8-9、10-12号外显子突变分析研究

目的　对肝豆状核变性(Wilson disease, WD)ATP7B基因的外显子8-9、10-12进行DNA测序并分析。方法　50例WD患者和20例对照正常人提取基因组DNA, PCR扩增ATP7B第8-9（约1100bp）、10-12号外显子(约850bp),对所有患者及对照组DNA外显子-内含子扩增产物行直接双向测序。结果　50例WD患者, 11例为8号内含子nt53592A→G伴nt53671G→A的纯合性突变;4例为8号外显子Arg778Leu突变伴Leu770Leu同义突变; 10-12号外显子5例存在外显子11 Gly790Arg杂合错义突变; 11例存在外显子12 Arg952Lys杂合错义突变; 2例伴有外显子12IIe929Val多态性。结论　外显子8、12为中国人ATP7B基因突变热点,已验证其为中国人常见突变位点;8内含子突变与ATP7B表达减少及WD发病相同（正常人未见）;外显子11突变率占所有病人的10%,以前报道甚少,也值得做进一步做大病例研究。     

华中和华东地区肝豆状核变性患者ATP7B基因第13号外显子突变的研究

目的 对华中和华东地区肝豆状核变性(HLD)患者ATP7B基因第13号外显子突变进行研究.方法 应用PCR-DNA测序技术对来自我国华中和华东地区的139例非同源家系的HLD患者的ATP7B基因第13号外显子进行检测,并与52名正常对照者进行比较.结果 正常对照组测序未见异常.HLD组共检出6种ATP7B基因的突变类型和1种多态,其中Gly988Val杂合突变为新的发现.HLD组突变及多态总的检出率为29.49%(41/139),染色体突变频率为15.83%(44/278);其中Pro992Leu纯合或杂合突变的检出率为23.02%(32/139),其染色体突变频率为12.59%(35/278).结论 ATP7B基因第13号外显子是华中和华东地区HLD患者的一个基因突变热区,是筛选HID可疑患者时优先检测的外显子之一.     

Using Fluorescence PCR Analysis For Gene Diagnosis and Carrier Detection of Chinese Wilson's Disease

Objective To develop a noval gene diagnostic method for detecting the high frequency spot of gene mutation in Chinese Wilson's disease by using the most advanced fluorescence PCR in order to make an early diagnosis and carrier detection. Methods 66 Chinese WD patients from 58 families had typical nanifestations of WD, and significant low levels of serum ceruioplasmin (CP), low levels of serum copper., high levels of urine copper. 55 family members (parents 33 and siblings 22) from 42 families of 58 WD families were normal phenotype with normal levels of CP. 30 in patients suffering from acute cerebrovascular disease, vertigo and headache had no blood relationship to be the control group. We got 5ml blood from each object to collect DNA, and designed two fluorcscent gene probes to hybridize with thc normal and mutant sequence of Arg778Leu respectively. The content of probe hybridization was concordant with the fluoresccin which was released during PCR process. The homozygote, heterozygote of WD and normal were identified by thc results of fluorescence PCR and through analysis we obtained the mutation rate of Arg778Leu. After that we selected 3 random samples (2 from WD patients, I from control group) for direct DNA sequencing in exon 8 of WD gencto testify the accuracy of fluorescence PCR. Results Among 66 Chinese WD patients, homozygous for mutation of Arg778Leu had been found in 5 cases and compound heterozygous found in 21 cases. and the mutation rate of Arg778Leu in our study was totally 39.4%. Of 55 normal phenotype family members. 12 individuals incluing parents 7 and siblings 5 were detected as heterozyous in which 11 (7 parents and 4 siblings) had been confirmed as WD gene carriers but not pre-symptomatic patients according to the throughtout examination and the normal CP. There were no mutation of Arg778Leu in all 30 control cases. Thc results of direct DNA sequencing of 3 at random samples were consilient to those results detected by fluorescence PCR. Conclusion The viewpant which the Arg778Leu mutation is the high frequency spot of Chincse WD gene should be supported by our study. Fluorescence PCR analysis is a rapid. accurate gene diagnostic method and demonstrates a high detecting rate. therefore. it is now the most advanced gene diagnostic method for Wilson's disease.     

经DNA测序证实的肝豆状核变性基因突变热区的研究

目的研究我国肝豆状核变性（ＷＤ）基因突变的特征。方法应用聚合酶链反应－单链构像多态（ＰＣＲ－ＳＳＣＰ）技术，结合ＤＮＡ测序技术，筛查４０个ＷＤ家系的５６例患者及无亲缘关系的６０名正常人的ＷＤ基因第５、８、１４号外显子（ｅｘｏｎ５，ｅｘｏｎ８，ｅｘｏｎ１４）的突变及多态。结果２１例患者（来自１５个ＷＤ家系）在ｅｘｏｎ８检出２种错义突变，占３７．５％（１５／４０），其中２例（来自同一家系）发生Ａｒｇ７７８Ｇｌｎ纯合子突变（２．５％），８例（分别来自８个ＷＤ家系）发生Ａｒｇ７７８Ｌｅｕ纯合子突变（２０．０％），余１１例（来自６个ＷＤ家系）发生Ａｒｇ７７８Ｌｅｕ杂合子突变（１５．０％，６／４０）。此外，在第８号外显子区域发现了两种多态；在ｅｘｏｎ５和ｅｘｏｎ１４侧翼的内含子区域各发现了１种新多态。这是我国首次经ＤＮＡ测序证实的ＷＤ基因突变热区。结论ｅｘｏｎ８为我国ＷＤ病人基因突变的热区之一，这对于建立准确快速的ＷＤ直接基因诊断方法具有重要意义，该测序方法对明确基因变异的具体部位和内容的具有一定的重要性。     

Mutation analysis and the correlation between genotype and phenotype of Arg778Leu mutation in chinese patients with Wilson disease

BACKGROUND: The defective gene (ATP7B) that causes Wilson disease (WD) codes for a putative copper-transporting P-type adenosine triphosphatase. After cloning of ATP7B, the spectrum of mutations and their clinical consequences have been investigated in patients with WD in different ethnic populations. However, the spectrum of mutations and the correlation of genotype-phenotype in the Chinese population have not been extensively studied. OBJECTIVE: To investigate the characterization of mutations of ATP7B and the correlation between genotype and phenotype in the Chinese population. METHODS: We studied 60 unrelated healthy Chinese and 65 unrelated Chinese families, including 84 patients with WD and 126 parents. Genomic DNA was prepared from peripheral blood leukocytes using a salt-precipitation method. Polymerase chain reaction single-strand conformation polymorphism and subsequent direct sequencing were used to identify the mutations and polymorphisms of ATP7B. Statistical analysis was performed using t test or chi(2) test. RESULTS: We identified 18 mutations (7 novel) and 11 polymorphisms (3 novel). The novel mutations are -36C-->T, Trp650ter, Gln914ter, 2810delT, Thr935Met, Arg1041Pro, and Glu1173Lys. The novel polymorphisms are 1168A-->G (Ile390Val), 2785A-->G (Ile929Val), and 3316G-->A (Val1106Ile). Two mutations, Arg778Leu and Thr935Met, are relatively frequent, representing 37.7% and 10.0% of patients, respectively. To our knowledge, we are the first to report the correlation between the genotype and phenotype of Arg778Leu. The result shows that Arg778Leu homozygotes are associated with the early onset of WD with hepatic presentation. CONCLUSIONS: The Arg778Leu and Thr935Met mutations are hot spots in the Chinese population. The features of mutations of ATP7B differ between the Chinese and Western ethnic populations. The Arg778Leu mutation has severe effects on the function of ATP7B. These findings are valuable for developing a fast and effective method to diagnose the presence of the WD gene.     

Novel ATP7B gene mutations in Chinese Han patients with hepatolenticular degeneration

BACKGROUND: ATP7B gene exon 8 Arg778Leu and exon 12 Arg952Lys are gene mutation hot spots in Chinese Han patients with hepatolenticular degeneration, or Wilson's disease (WD). However, the gene fragments are too short for detection and the mutation detection rate remains low.OBJECTIVE: To analyze DNA sequences of ATP7B gene exon 8-exon 9 and exon 10-exon 12 sections. DESIGN, TIME AND SETTING: A concurrent, non-randomized, controlled, genetic polymorphism study was performed at the Anhui Medical Genetics Center, Anhui, China from March to July in 2009.PARTICIPANTS: Fifty patients, who were admitted to the Department of Neurology at the First Affiliated Hospital of Anhui Traditional Chinese Medical College between March and July in 2009, were diagnosed with WD. The WD group comprised 32 males and 18 females, with an average age of (18.8 ± 8.3) years. WD was confirmed by clinical observation, as well as physical, imaging, and biochemical examinations, including testing for serum copper, ceruloplasmin, and copper oxidase. The control group comprised 20 normal subjects, who underwent physical examination at the First Affiliated Hospital of Anhui Traditional Chinese Medical College, and included 13 males and 7 females, with an average age of (27.9 ± 2.4) years. All subjects were Chinese Han population.METHODS: Genomic DNA was extracted from 50 WD patients and 20 normal controls. Polymerase chain reaction amplification of ATP7B gene exon 8-exon 9 (about 1 100 bp) and exon 10-exon 12 (about 850 bp) segments was performed. DNA exon-intron amplification products from all subjects were processed through direct bidirectional sequencing, and sequencing results were analyzed. MAIN OUTCOME MEASURES: Sequence changes of ATP7B gene exon 8-exon 9 and exon 10-exon 12 segments.RESULTS: In the 50 included WD patients, ATP7B gene intron 8 nt53592A → G with nt53671G → A homozygous mutation was detected between exon 8-exon 9 in seven cases; exon 8 Arg778Leu mutations with Leu770Leu synonymous mutation was detected in four cases; exon 11 Gly790Arg heterozygous missense mutation between exon 10-exon 12 was found in four cases; exon 12 Arg952Lys heterozygous missense mutation was seen in 11 cases; and two additional cases were associated with exon 12IIe929Val polymorphism.CONCLUSION: ATP7B gene intron 8 mutation is a possible pathogenic mutation that is associated with WD pathogenesis. The exon 11 mutation rate accounts for 8% of all WD patients, and the very few previously reported cases deserve further study.     

Apolipoprotein E genotype analysis in Chinese Han ethnic children with Wilson's disease, with a concentration on those homozygous for R778L

Wilson's disease (WD) is an autosomal recessive disorder of copper metabolism caused by a large number of different mutations in the ATP7B gene. R778L mutation is mostly observed in Chinese, Japanese and Korean patients, whereas the H1069Q point mutation in the ATP7B gene is the most frequent mutation in European patients with WD. In our previous study we did not find a significant correlation between genotype and phenotype (age of onset and clinical presentation) in patients homozygous (37 patients) or heterozygous (52 patients) for R778L. It was reported that European patients homozygous for H1069Q who were also homozygous for the ApoE genotype ε3/3 developed clinical symptoms 5–11 years later than did patients with genotypes other than ApoE ε3/3. In the present study (i) we firstly observed that ApoE ε3/3 did not delay the onset of WD; (ii) no association between ApoE genotype and WD clinical presentation in Chinese Han children, including those patients homozygous for R778L. Thus we conclude that the onset of WD in Chinese children is not related to ApoE ε3/3, although the high frequency of ApoE ε3/3 in Chinese Han children with WD was not significantly different from that in controls.     

应用限制性酶谱分析法快速检出Wilson病基因突变热点

目的建立Wilson病（WD）基因突变热点的快速检出方法，并探讨其在WD临床可疑患者诊断中的价值。方法PCR扩增我国WD基因的突变热区──第8号和12号外显子，分别以限制性内切酶MspI和TaiI消化扩增产物，2％琼脂糖凝胶电泳分离，得出相应限制性酶切图谱并进行分析。56例非同源家系的WD患者及60例正常对照进行了该项检测。其中44例同时进行这两个外显子的测序检测。结果37．5％（21／56）的WD患者在第8号外显子检测到Arg778Leu／Gln点突变，其中12例为纯合点突变，9例为杂合点突变，染色体突变频率为29．5％（33／112）。16．1％（9／56）的患者在第12号外显子检测到Thr935Met点突变，均为杂合点突变，染色体突变频率为8．0％（9／112）。结果与测序相符。结论采用限制性酶谱分析法可准确检出WD基因最常见的两个突变点，有助于对临床可疑患者进行诊断。并具有简便快速、结果清晰可靠、不需用同位素等优点，易于推广应用。     

肝豆状核变性8号外显子778密码子基因突变的酶切检测

目的应用酶切方法对中国人肝豆状核变性患者ＡＴＰ７Ｂ基因中的高频突变点进行检测，并对家系进行基因诊断分析。方法根据高频突变点所处序列设计合适的内切酶ＭｓｐⅠ，对中国人肝豆状核变性３９个家系４５个患者以及６０例正常人的ＡＴＰ７Ｂ基因８号外显子ＰＣＲ扩增后进行酶切分析。对有异常者进行序列分析（自动测序）。结果正常人组未见异常，患者组有２例突变纯合子，占患者总数４４％，１１例杂合子，占患者总数２４４％。酶切的异常率为２８８％。序列分析证实所有异常表现者均为Ｇ２２７３Ｔ置换，即Ａｒｇ７７８Ｌｅｕ突变。并检测和分析了３个高频突变家系。结论ＡＴＰ７Ｂ基因的８号外显子７７８密码子为中国人肝豆状核变性患者的高频突变点。用ＰＣＲ－酶切的方法可以作为检测中国人肝豆状核变性患者基因突变的快速诊断方法     

Marked phenotypic variation in a family with a new myelin protein zero mutation

Myelin protein zero (MPZ) is a member of the immunoglobulin gene superfamily, which has a role in myelin compaction. MPZ gene mutations cause mostly demyelinating neuropathies of the Charcot-Marie-Tooth 1B type (CMT1B), but axonal CMT have been described as well. There is a broad spectrum of phenotypic manifestation of neuropathies caused by MPZ mutations. Some mutations of MPZ cause severe early-onset neuropathies such as Dejerine-Sottas disease, while others cause the classical CMT phenotype with normal early milestones but development of disability during the first two decades of life. We describe a family in which five members of three consecutive generations had a heterozygous mutation in nucleotide position 143 with a T-C transition in exon 2 of the MPZ gene. The resulting substitution of Leu48 with proline has not been previously described. The age of onset of symptoms varied from 8 months to 41 years. The marked variation of the age of disease onset and clinical phenotype in this one family, related to the same MPZ mutation, suggests that in addition to the type and intragenic location of the mutation, other putative modifying gene(s) are regulating MPZ gene expression, mRNA stability and posttranslational protein modification and may have an important effect on the ultimate clinical phenotype.     

74例肝豆状核变性患者中ATP7B基因七种新突变的发现

目的 分析中国人肝豆状核变性（Wilson disease,WD）患者ATP7B基因突变的分布特征,建立利用变性高效液相色谱（DHPLC）技术对Wilson病进行基因诊断的方法,并评价其在临床的应用价值.方法 对临床确诊为Wilson病的74例患者及50名健康人抽取外周静脉血提取基因组DNA.以患者和健康人的DNA为模板,分别对ATP7B基因的21个外显子进行PCR扩增.取PCR产物应用DHPLC技术在部分变性条件下检测突变并DNA测序证实突变位点.结果 利用DHPLC技术筛查并经测序证实,共发现22种ATP7B基因突变类型,其中7种是新发现的,同时发现11种多态,其中3种是新发现的.第8外显子Arg778Leu突变率最高,其频率为25.0%.其次,2356-2A＞G突变频率为3.4%,Arg919Gly突变频率为2.7%,其他外显子突变频率均在1.0%～2.0%之间.结论 中国人的WD基因突变具有多样性特点,热点突变是第8外显子Arg778Leu.DHPLC具有高通量、敏感、准确且经济的特点,适合于大样本的筛查且能够发现未知的突变,是一种有临床应用价值的基因诊断技术.