婴儿,新生 , 枫糖尿症 , 磁共振频谱," /> 婴儿,新生 , 枫糖尿症 , 磁共振频谱,"/> <span style="font-size:14px;line-height:2;">新生儿枫糖尿症早期诊断2例并文献复习</span>
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发育医学电子杂志  2014, Vol. 2 Issue (1): 28-31    
  围产医学   临床经验交流 |新生儿 |
新生儿枫糖尿症早期诊断2例并文献复习
于文婷 毛健
中国医科大学附属盛京医院,沈阳 110004
The early diagnosis for maple syrup urine disease of neonates: report of two cases and review of literture
YU Wen-ting ,MAO Jian
Shengjing Hospital Affiliated to China Medical University, Shenyang 110004,China
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摘要 【摘要】 目的 探讨新生儿期枫糖尿症临床特点、影像学头核磁频谱特点,以及基因遗传学特征,以便做到早发现、早诊断和早治疗。方法 新生儿期枫糖尿症患儿血和尿的遗传代谢筛查、基因学检测和头磁共振频谱检查。结果 2 例患儿临床存在喂养困难和神经系统异常表现,并存在代谢紊乱。2 例患儿血和尿代谢筛查结果符合枫糖尿病诊断,早期完善头部磁共振及频谱检查,发现头磁共振表现为广泛的脑白质受累,尤其是髓鞘发育成熟部位,频谱上均发现了0.9 ppm 处相对特异性波峰。基因学检查发现病例1BCKDHA 基因的一个杂合突变:2 号外显子c.117dupC 为致病突变;病例2BCKDHA 基因的一个杂合突变:8 号外显子c.1000G 位点为致病突变。结论 枫糖尿症临床常表现喂养困难、反应低下等,早期头MR 及MRS 的特征性表现有助于更早进行诊断,而基因分析可了解枫糖尿症患儿的基因突变情况, 利于产前诊断, 为枫糖尿症家庭提供帮助。
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关键词:  婴儿')" href="#">婴儿  新生   枫糖尿症   磁共振频谱    
Abstract: 【Abstract】 Objective To analyze and summarize clinical manifestation, MRS findings and gene
characteristics of maple syrup urine disease(MSUD) of neonates, and proceed early screening, diagnosis and treatment.Method The MSUD neonates received tandem mass spectrum and gas chromatography examination, gene detection and the MRS examination. Result Their main clinical features are poor feeding, and nervous system and associated metabolic disorders. Two cases both received tandem mass spectrum and gas chromatography examination and met the diagnosis of MSUD. The gene testing showed both mutation of the BCKDHA gene. Their magnetic resonance showed a wide range of brain white matter involvement, especially the myelin sheath mature site and magnetic resonance spectroscopy showed an abnormal branchedchain amino acids (BCAA) and branched- chain alpha-keto acids (BCKA) peak at 0.99 ppm. Conclusion Newborns with MSUD often had early appeared non-specific symptoms with poor feeding, decreased responsiveness and convulsions.The specific manifestations of MRS and MR can help us to have an early diagnosis and treatment. The gene analysis of MSUD allowed preliminary understanding of gene mutations in the MSUD families and made prenatal diagnosis which is helpful for consultation in the second pregnancy.
Key words:  Neonate    Maple syrup urine disease    Magnetic resonace spectroscopy
收稿日期:  2014-01-07                出版日期:  2014-01-30      发布日期:  2019-09-06      期的出版日期:  2014-01-30
通讯作者:  毛健http://www.sj-hospital.org/show.php?mesid=507    E-mail:  maoj@sj-hospital.org
引用本文:    
于文婷 毛健. 新生儿枫糖尿症早期诊断2例并文献复习[J]. 发育医学电子杂志, 2014, 2(1): 28-31.
YU Wen-ting , MAO Jian. The early diagnosis for maple syrup urine disease of neonates: report of two cases and review of literture. Journal of Developmental Medicine(Electronic Version), 2014, 2(1): 28-31.
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