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云南玉溪市一家族性肥厚型心肌病家系致病基因筛查
作者姓名:乔铅  郝应禄  李燕萍  刘海英  李婷婷  钱宝堂  刘芳言
作者单位:昆明医科大学第六附属医院玉溪市人民医院心内科
基金项目:基金: 云南省自然科学基金资助项目 (2013FZ258);
摘    要:目的 对云南省玉溪市一个家族性肥厚型心肌病的家系成员进行候选致病基因筛查, 分析基因型和表型之间的关系, 为家族性肥厚型心肌病的分子遗传学机制研究、早期筛查、早期干预治疗提供重要的理论基础.方法 对家系成员进行详细的病史采集、体格检查、常规十二导联心电图、心脏彩超检查;采集外周静脉血样本进行基因学检测.绘制家系遗传图谱, 分析家系遗传特点、基因型及临床表型.结果 该家系肥厚型心肌病的遗传方式以X连锁显性遗传为主.候选基因筛查发现家系中携带GLA、ZFPM2、SCN5A基因的错义突变, 且翻译的氨基酸发生改变.结论 X连锁显性遗传是该家系HCM主要的遗传方式.GLA c.167G>A (p.Cys56Tyr) 杂合或半合子错义突变可能是该家系肥厚型非梗阻性心肌病的主要致病突变.ZFPM2 c.1332G>C (p.Lys444Asn) 杂合错义突变和SCN5A c.5216G>A (p.Arg1739Gln) 杂合错义突变在该家系中临床意义未明.

关 键 词:肥厚型心肌病    基因突变    表型
收稿时间:2017-10-19

Genetic Screening of Familial Hypertrophic Cardiomyopathy in Yuxi Yunnan
Abstract:Objective Through the screening of candidate pathogenic gene among family members of a family with familial hypertrophic cardiomyopathy in Yuxi, Yunnan Province, the study is designed to analyze the relationship between genotype and phenotype and to provide an important theoretical basis for the research of molecular genetic mechanism, early screening and early intervention of familial hypertrophic cardiomyopathy.Me thods A detailed medical history was collected and physical examination and routine twelve lead electrocardiogram and cardiac ultrasonography examination were performed among the family members. The peripheral venous blood samples were collected for genetic testing. The genetic map was drawn and the genetic characteristics, genotype and clinical phenotype were analyzed. Re s ults In this family, the dominant inheritance mode of hypertrophic cardiomyopathy is X-linked dominant inheritance. Candidate genes screening showed that a missense mutation was found in the GLA, ZFPM2, SCN5 A genes and the translated amino acids were changed.Conclus ion X-linked dominant inheritance is the main genetic mode of HCM in this family. GLA c.167 G> A (p.Cys56 Tyr) heterozygous or hemizygous missense mutation may be the major pathogenic mutation in this family with non-obstructive hypertrophic cardiomyopathy. The clinical significance of ZFPM2 c.1332 G> C (p.Lys444 Asn) heterozygous missense mutation and SCN5 A c.5216 G> A (p.Arg1739 Gln) heterozygous missense mutation in this family is undetermined.
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