实用医学杂志 ›› 2022, Vol. 38 ›› Issue (23): 2973-2979.doi: 10.3969/j.issn.1006⁃5725.2022.23.015

• 临床研究 • 上一篇    下一篇

基于毛细管电泳平台的单基因病携带者筛查应用 

方玉琴 张苗苗 李景然 唐俊湘 王朝红 朱健生    

  1. 安徽医科大学附属妇幼保健院(合肥 230000)

  • 出版日期:2022-12-10 发布日期:2022-12-10
  • 通讯作者: 朱健生 E⁃mail:593130772@qq.com
  • 基金资助:
    安徽省重点研究与开发计划项目(编号 :2022e07020031);安徽省妇幼保健院院级科研项目重点项目(编号:zd2021⁃1⁃3);安徽医科大学科研基金(编号:2020xkj234)

Study on the application of single gene disease carrier screening based on capillary electrophoresis plat⁃ form

FANG Yuqin,ZHANG Miaomiao,LI Jingran,TANG Junxiang,WANG Chaohong,ZHU Jiansheng.   

  1. Affili⁃ ated Maternity and Child Health Hospital of Anhui Medical UniversityHefei 230000China

  • Online:2022-12-10 Published:2022-12-10
  • Contact: ZHU Jiansheng E⁃mail:593130772@qq.com

摘要:

目的 了解中国安徽地区人群致病基因携带情况以及常见变异,探讨在临床实施扩展性携 带者筛查(expanded carrier screening,ECS)的应用价值。方法 纳入 2021 1 月至 2022 8 月来安徽医科 大学附属妇幼保健院就诊的表型正常、无遗传病家族史的 517 例育龄人群进行 ECS,采用基于毛细管电泳 平台的一代测序分析技术检测与15种疾病相关的21个基因中的410种致病变异,对阳性携带者的配偶召回 进行相关基因检测。结果 在517例接受 ECS 的育龄人群和 17 例接受目标基因测序的配偶中,94 例被确 定为至少一种疾病的携带者,总携带率为 18.2%(94/517)。携带率最高的三种疾病分别为遗传性耳聋 6.4%,33/517)、肝豆状核变性(3.1%,16/517)和先天性肾上腺皮质增生症(2.5%,13/517)。共检出 5 3.57%,5/140)高风险夫妇,经过遗传咨询后其中 2 对(40%,2/5)选择产前诊断,羊水验证结果均未检出指 定基因范围内的致病变异。结论 在临床实施 ECS 是可行且必要的,在孕前或孕早期进行遗传病携带者 筛查,结合产前诊断和辅助生殖等手段,可有效避免严重遗传病的发生。

关键词:

携带者筛查, 携带率, 单基因遗传病, 杂合突变

Abstract:

Objective The study aimed to investigate the carrying situation of pathogenic genes and common variations in the population in Anhui,China,and to explore the application value of expanded carrier screening(ECS)in clinical practice. Methods A total of 517 childbearing ⁃age people with normal phenotypes and no family history of genetic diseases in our hospital from 2021 to 2022 were enrolled for ECS. The first genera⁃ tion sequencing analysis technology based on the capillary electrophoresis platform was used to detect 410 pathogenic variants in 21 genes related to 15 diseases,and the spouses of positive carriers would be recalled for related genetic testing. Results Among 517 childbearing⁃age people receiving ECS and 17 spouses receiving target gene sequenc⁃ ing,94 were identified as carriers of at least one disease,with a total carrier rate of 18.2%(94/517). The three diseases with the highest carrying rate were hereditary deafness(6.4%,33/517),hepatolenticular degeneration (3.1%,16/517)and congenital adrenal hyperplasia(2.5%,13/517). A total of 5 high⁃risk couples(3.57%,5/140 were detected. After genetic counseling,2 of them(40%,2/5)chose prenatal diagnosis. The amniotic fluid vali⁃ dation results showed that no pathogenic variation within the designated gene range was detected. Conclusions It is feasible and necessary to implement ECS in clinical practice. Screening of carriers of genetic diseases before preg⁃ nancy or in early pregnancy,combined with prenatal diagnosis and assisted reproduction,can effectively avoid the occurrence of serious genetic diseases.

Key words:

carrier screening, carrying rate, monogenic genetic diseases, heterozygous mutation