关于线粒体脑肌病MERRF和MELAS的癫痫发作

报告线粒体脑肌病ＭＥＲＲＦ和ＭＥＬＡＳ各３例的临床特点，并结合文献探讨其癫痫发作的发病机制。提出对于青少年期癫痫应注意鉴别线粒体脑肌病ＭＥＲＲＦ和ＭＥＬＡＳ。     

线粒体肌病与线粒体脑肌病的酶组织化学和超微结构改变

目的：探讨原发性线粒体肌病与脑肌病的病理特征及临床特点。方法：对11例原发性线粒体肌病与脑肌病患者的临床表现，酶组织化学及超微结构进行分析，结果：11例MGT染色均发现有不整红边纤维（RRF），其中单纯表现为肌无力的患者7例，合并中构神经系统受累者4例，RRF出现比例为6．4％－10．3％，电镜观察11例，9例表现为线粒体数目增多，形态异常，嵴排列紊乱等。均可见线粒体内类结晶状包涵体。2例线粒体改变只见数量增多，未见其他异常。结论：光镜下酶组化染色发现典型RRF，对线粒体肌病与脑肌病的初步论断有重要价值。电镜观察肌膜下线粒体异常增多且形态异常，特别是线粒体内类结晶状包涵体的出现，对本病的确诊有重要意义。     

线粒体肌病和脑肌病患者骨骼肌细胞线粒体DNA缺失分析

目的为了检测线粒体肌病和脑肌病患者的骨骼肌细胞的线粒体ＤＮＡ的缺失情况。方法从６例原发性线粒体肌病和１例脑肌病患者的骨骼肌活检标本中，提取总ＤＮＡ，以线粒体ＤＮＡ全长为探针进行分子杂交。结果发现１例ＭＥＲＲＦ患者有５ｋｂ的线粒体ＤＮＡ基因缺失，另１例线粒体肌病患者有１５ｋｂ的线粒体ＤＮＡ基因缺失，剂量分析表明缺失型线粒体ＤＮＡ分别占总线粒体ＤＮＡ的１９．３％和１０．７％。结论线粒体ＤＮＡ基因缺失是线粒体疾病的重要病因之一     

16例线粒体肌病和线粒体脑肌病电镜观察分析

目的探讨线粒体肌病与脑肌病患者肌肉的超微结构特征,分析该病的病因和可能的发病机制。方法对16例线粒体肌病与脑肌病患者的肌活检组织进行光镜和电镜超微病理观察。结果电镜观察16例,在肌原纤维间和肌膜下可见弥漫的线粒体数目增多,13例表现为形态异常,可见巨大线粒体,嵴结构不清,排列紊乱,呈同心圆样,均可见线粒体内类结晶状包涵体,有的同时伴有糖原颗粒的异常增多、脂滴沉积及溶酶体异常,有的线粒体只能靠双层膜结构及残存的嵴被识别。3例仅线粒体数量增多,未见其他异常。结论电镜观察肌膜下和肌原纤维间线粒体异常增多且形态异常,特别是线粒体内类结晶状包涵体,对本病的诊断有重要价值。     

线粒体肌病及脑肌病

线粒体肌病及脑肌病李大年自Ｌｕｆｔ等于１９６２年首次采用改良ＧｏｍｏｒｉＴｒｉｃｈｒｏｍｅ染色（ＭＧＴ）发现肌纤维中有不整红边纤维（ＲＲＦ）并诊断首例线粒体肌病以来，继而发现此类线粒体疾病也可同时累及中枢神经系统，并引起多种线粒体脑肌病的临床综合征［...     

线粒体脑肌病的临床、病理与神经电生理

目的探讨线粒体脑肌病的临床、肌肉病理及神经电生理特点，以便早期诊断。方法对6例确诊的线粒体脑肌病患者的临床表现、肌肉组织光镜和超微结构改变以及神经电生理改变进行了回顾性分析。结果本组患者的临床特征主要以运动不耐受，阵挛、抽搐发作，精神障碍，共济失调为主。6例患者中4例发现破碎红纤维（RRF），其平均比例为5．3％；超微结构观察有线粒体异常及糖原颗粒沉积，其中有2例发现有典型晶格状包涵体。以癫痫发作为主要临床表现的患者脑电图明显异常；肌电图以神经源性改变4例，占本组病例的4／6；听觉诱发电位（BAEP）、体感诱发电位（SEP）异常3例，占3／6。结论线粒体脑肌病的临床表现复杂多样，诊断主要依赖于临床特征分析和肌肉活检；电镜超微结构改变为线粒体病的主要诊断依据；神经电生理改变对病理损伤累及范围和程度方面有一定的参考价值。     

线粒体脑肌病的临床与脑电图

报告９例线粒体脑肌病。６例肌活检的病人中，５例见不整红边红纤维（ＲＲＦ），另１例电子显微镜下显示线粒体数量，形态及大小的异常，并见较多糖原颗粒及脂滴。进行血乳酸测定的５例病人，均有不同程度的血清乳酸水平的增高。在５例影像学检查（ＣＴ或ＭＲＩ）的病人中，４例显示一侧或双侧的大脑病变，１例仅表现为侧脑室的对称性扩大。２例基底节区有钙化。１例尸检，脑的改变是以大脑的层状坏死为突出表现。８例进行了脑电图（ＥＥＧ）检查，除１例正常外，余均异常。２例Ｋｅａｒｎｓ－Ｓａｙｒｅ综合征的ＥＥＧ改变均比乳酸中毒性线粒体脑肌病综合征（ＭＥＬＡＳ）轻微。异常表现为：①不同程度的弥散性减慢，有或没有局灶性偏盛，正常的α节律减少或消失；②普遍的或局灶的爆发活动，包括慢波、棘波、尖波及棘慢波综合的爆发。     

线粒体脑肌病的临床与病理

目的探讨线粒体脑肌病的临床与肌肉病理特点。方法对16例肌活检证实的线粒体脑肌病病例的临床表现、肌肉组织化学及超微结构进行分析。结果16例患者破碎红纤维(RRF)的平均比例为5.9%,11例有中央核增多,13例的SDH/CCO双染示12例有蓝纤维,且与RRF的分布一致。超微结构观察有4例找到典型晶格状包涵体。结论SDH/CCO双染有蓝纤维为线粒体肌病的诊断提供了依据,借此可与其他肌病鉴别。     

多种形态类结晶包涵体并存的线粒体肌病1例报告

线粒体肌病是一组由于线粒体遗传基因缺陷而导致的以线粒体功能障碍为主要特征的肌病，目前认为，肌纤维内线粒体类结晶包涵体的存在对诊断该病具有重要意义。本文报告1例线粒体肌病患者，发现超微病理表现丰富,特别是线粒体内类结晶包涵体形态、数目之异常，不同于以往国内、外报告的特征，现报告如下。     

多发性肌炎与自身抗体

检测了８５例多发性肌炎（ＰＭ）患者血中常见自身抗体结果显示，ＲＦ、ＡＮＡ、抗（ｕ１）ＲＮＰ、抗Ｓｍ、抗ＳＳＡ、抗ＳＳＢ及抗Ｓｃｌ－７０的阳性率分别为４０．７％、２９．４％、７．７％、３．４％、５．１％、１．７％及５％，而抗ｄｓＤＮＡ、抗Ｊｏ－１、抗核糖体抗体的阳性率均为０。患者血中自身抗体阳性与否与Ｉｇ、Ｃ３、ＥＳＲ及肌酶活性水平关系不大。讨论了各自身抗体检测对ＰＭ的诊断价值。     

A large-scale deletion of mitochondrial DNA in a case with pure mitochondrial myopathy and neuropathy

Here we report the findings from a male patient with myopathy and neuropathy, who has a large-scale deletion of the mitochondrial genome at nucleotides 6570–14150. In the patient’s history, muscle cramps with intermittent weakness and polyneuropathy with disturbed micturition were the predominant symptoms. Morphological examination of a muscle biopsy sample revealed numerous ragged red fibers and prominent paracrystalline intramitochondrial inclusions. The sural nerve biopsy sample disclosed a chronically progressive neuropathy, predominantly axonal in type with a minor demyelinating component. In previous studies the clinical symptoms mentioned above have been related to point mutations at various positions in the mitochondrial DNA (mtDNA). The present study is the first to describe a large (8 kb) deletion of the mtDNA which had apparently caused myopathy and polyneuropathy without encephalopathy. Received: 27 July 1995 / Revised, accepted: 4 December 1995     

线粒体肌病和线粒体脑肌病组织化学及电镜的研究

本文报告了2例线粒体肌病、3例线粒体脑肌病(MALES1例、MER-RF2例)。所有病例的速冻连续切片的GT染色均见有RRF。在HE—NADH—TR、ATP酶、PAS、、磷酸化酶及SND染色中均见有RRF样增强纤维。细胞色素C氧化酶染色中有2例的切片出现阴性染色肌纤维、考虑为复合体Ⅳ活性低下,余3例染色正常。电镜下观察到除有大量形态异常的线粒体外,并在这些线粒体内见有结晶状、板层状及同心圆样的包涵体。     

Cortical reflex myoclonus in patients with the mitochondrial DNA transfer RNALys(8344) (MERRF) mutation

Five patients from three families with the syndrome of myoclonic epilepsy and ragged red fibres (MERRF), associated with the mitochondrial DNA point mutation at position 8344, were studied neurophysiologically to determine the characteristics of their myoclonus. The findings were those of cortical reflex myoclonus, with enlarged cortical somatosensory evoked potentials and late reflex responses to peripheral nerve stimulation. Electroencephalography showed paroxysmal spike and polyspike and wave discharges, with photic sensitivity. This pattern of electrophysiological abnormalities was uniform, despite considerable variation in severity of myoclonus. Although a consistent finding, cortical reflex myoclonus is not specific to MERRF amongst myoclonic syndromes.     

线粒体形态学变化与急性缺血性卒中相关性的研究进展

线粒体作为细胞内高度动态的细胞器,通过不断地分裂、融合等形态学变化来调节自身 的数量、形态和分布,进而间接决定着组织细胞的功能甚至存亡,这一机制普遍存在于哺乳动物细 胞内各种生理和病理过程中。缺血性卒中病理生理所涉及的钙超载、氧化应激和细胞凋亡等机制均 与线粒体的分裂、融合失衡密不可分。因此,充分了解和研究线粒体融合、分裂与卒中致病因素之间 的联系,将有利于找到治疗卒中的新靶点和新方法。     

Genetic and biochemical findings in Chinese children with Leigh syndrome

This study investigated the genetic and enzymological features of Leigh syndrome due to respiratory chain complex deficiency in Chinese patients. The clinical features of 75 patients were recorded. Mitochondrial respiratory chain enzyme activities were determined via spectrophotometry. Mitochondrial gene sequence analysis was performed in 23 patients. Five core pedigrees were investigated via restriction fragment length polymorphism and gene sequencing. Psychomotor retardation (55%), motor regression (20%), weakness (29%), and epilepsy (25%) were the most frequent manifestations. Sixty-four patients (85.3%) had isolated respiratory complex deficiencies: complex I was seen in 28 patients (37.3%); complex II, seven (9.3%); complex III, six (8%); complex IV, ten (13.3%); and complex V, 13 patients (17.3%). Eleven patients (14.7%) had combined complex deficiencies. Mitochondrial DNA mutations were detected in 10 patients. Eight point mutations were found in mitochondrial structural genes: m.4833A > G in ND2, m.10191T > C in ND3, m.12338T > C and m.13513G > A in ND5, m.14502T > C and m.14487T > C in ND6, m.8108A > G in COXII, and m.8993T > G in ATPase6. Three mutations were found in tRNA genes: m.4395A > G in tRNA-Gln, m.10454T > C in tRNA-Arg, and m.5587T > C in tRNA-Ala. One patient and their mother both had the m.12338T > C and m.8993T > C mutations. In conclusion, mitochondrial respiratory chain complex I deficiency and structural gene mutations frequently occur in Chinese Leigh syndrome patients.     

线粒体脑肌病患者的基因突变研究

目的 探讨线粒体脑肌病患者骨骼肌细胞线粒体DNA基因突变情况及发病机制。方法 观察总结5例线粒体脑肌病患者的临床表现,影像学变化特点,并应用PCR、限制性内切酶BglⅠ、ApaⅠ酶切,PAGE电泳鉴定DNA片段长度的方法,检测5例患者骨骼肌细胞中mtDNA是否发生nt3243和8344位点A→G突变。结果 5例患者（3例MELAS和2例MERRF）在临床表现和影像学改变等方面均与国外学者的研究结果相符。1例MELAS患者仅存在3243A→G点突变,1例MERRF患者存在8344A→G点突变,1例MERRF上述2个位点均存在突变。另2例呈家系起病的MELAS患者这2个位点都无突变。结论 3243及8344位点突变分别与MELAS和MERRF的发病有关,MERRF患者可以同时存在上述2个位点的突变。临床表现仍是确诊和分类的主要依据。Ⅰ     

全基因组检测线粒体脑肌病的基因突变研究

目的探讨全基因组检测线粒体脑肌病(ME)基因突变的临床意义。方法分析8例ME的临床特征、24h视频脑电图(VEEG)、肌电图(EMG)、头颅MRI、全基因组检测基因突变。结果 8例全基因组检测基因突变表明,存在核基因突变8例、有氨基酸改变7例、线粒体基因突变8例;其中t RNA基因突变5例、TRNL1基因突变4例、ATP6基因突变3例、ND5和TRNS2基因突变各1例。核酸3243AG改变4例(50%),其他有8860AG,11719GA,14766CT,8993TG等4例(50%),氨基酸改变4例。结论ME患者大多存在核基因的突变,线粒体的5个mt DNA均可发生突变。本组患者核酸改变仅50%发生在3243位点,检测核基因和线粒体基因是诊断ME的依据之一。     

Mitochondrial Dysfunction and Biogenesis in Neurodegenerative diseases: Pathogenesis and Treatment

Neurodegenerative diseases are a heterogeneous group of disorders that are incurable and characterized by the progressive degeneration of the function and structure of the central nervous system (CNS) for reasons that are not yet understood. Neurodegeneration is the umbrella term for the progressive death of nerve cells and loss of brain tissue. Because of their high energy requirements, neurons are especially vulnerable to injury and death from dysfunctional mitochondria. Widespread damage to mitochondria causes cells to die because they can no longer produce enough energy. Several lines of pathological and physiological evidence reveal that impaired mitochondrial function and dynamics play crucial roles in aging and pathogenesis of neurodegenerative diseases. As mitochondria are the major intracellular organelles that regulate both cell survival and death, they are highly considered as a potential target for pharmacological‐based therapies. The purpose of this review was to present the current status of our knowledge and understanding of the involvement of mitochondrial dysfunction in pathogenesis of neurodegenerative diseases including Alzheimer's disease (AD), Parkinson's disease (PD), Huntington's disease (HD), and amyotrophic lateral sclerosis (ALS) and the importance of mitochondrial biogenesis as a potential novel therapeutic target for their treatment. Likewise, we highlight a concise overview of the key roles of mitochondrial electron transport chain (ETC.) complexes as well as mitochondrial biogenesis regulators regarding those diseases.