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家族性肥厚型心肌病责任基因的定位和致病机制

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摘 要 家族性肥厚型心肌病是常染色体显性遗传性疾病,单一责任等位基因突变即可致病。近十年来使用微卫星基因标记技术,在该病家系中发现了7种致病责任基因,致病机制有“肽类毒剂”和“无效等位基因”两种学说。作者对责任基因的定位、肌原纤维节中突变蛋白的致病机制作一综述,并分析突变基因型与其表型的关系,以利于疾病的诊断和治疗。

关键词: 遗传性疾病,心肌病,肥厚性

  家族性肥厚型心肌病(FHCM)是以心肌肥厚、病理组织心肌纤维肥大、排列紊乱为特征的遗传性疾病,系常染色体显性遗传,单一责任等位基因突变即可致病。约占肥厚型心肌病的80%,临床表现有不同的基因表型,患者可有呼吸困难、心悸、眩晕等症状,严重者可致心脏衰竭、休克和猝死,亦有少数健康年轻人以猝死为唯一表现。年死亡率约3%~5%。疾病外显与年龄相关,少数具有突变基因的家系成员疾病可终生不外显。正是由于FHCM基因表型具有多样性和一定程度的不可预测性,使目前临床上缺乏肥厚型心肌病敏感的诊断标准。近十年来,致病责任基因的发现,使我们对FHCM病因、发病机制、诊断和治疗有了新的认识。
目录:
1 连锁分析和致病基因的确定
2 基因型与基因表型的关系
3 FHCM发病机制
4 FHCM基因诊断、治疗展望


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