中国神经再生研究(英文版) ›› 2013, Vol. 8 ›› Issue (20): 1907-1918.doi: 10.3969/j.issn.1673-5374.2013.20.010

• 原著:神经损伤修复保护与再生 • 上一篇    

中国东北人群肢带型肌营养不良的亚型分布

  

  • 收稿日期:2013-05-26 修回日期:2013-06-25 出版日期:2013-07-15 发布日期:2013-07-15

Limb-girdle muscular dystrophy subtypes First-reported cohort from northeastern China

Omar Abdulmonem Mahmood1, 2, Xinmei Jiang1, Qi Zhang1   

  1. 1 Department of Neurology, Affiliated First Hospital of Jilin University, Changchun 130021, Jilin Province, China
    2 Department of Neuromedicine, Mosul Medical College, 41002, Mosul, Iraq
  • Received:2013-05-26 Revised:2013-06-25 Online:2013-07-15 Published:2013-07-15
  • Contact: Xinmei Jiang, M.D., Professor, Department of Neurology, Affiliated First Hospital of Jilin University, Changchun 130021, Jilin Province, China, jiangxinmei55@ yahoo.com.cn.
  • About author:Omar Abdulmonem Mahmood, Ph.D.

摘要:

在不同人种中各种肢带型肌营养不良亚型出现的相对频率变化很大,为更好的了解不同亚型肢带型肌营养不良患者的临床特征和生化表现。实验收集长春吉林大学第一医院神经内科求治的68例中国肢带型肌营养不良患者,其中2A亚型 12例(17%),2B亚型10例(15%),2D亚型2例(3%),1C亚型2例(3%),剩余42例(62%)患者归为未分类肢带型肌营养不良。说明中国东北人群肢带型肌营养不良的各亚型分布与国外研究结果相似,但肢带型肌营养不良2A和2D亚型在中国东北人群中发生率较高。对各亚型患者进行肌肉活检发现肢带型肌营养不良2D亚型患者肌肉组织存在镶边空泡和广泛炎性细胞浸润,2A亚型患者肌肉组织较少坏死、再生及炎症浸润、存在大量小叶性纤维及镶边空泡,且与2D亚型比较,肢带型肌营养不良2A亚型发展没有那么活跃且慢性进展。而2B亚型患者可见肌肉炎性改变,肢带型肌营养不良1C亚型存在大量分叶状纤维。因而可以通过上述差异进行各亚型的区分。

关键词: 神经再生, 神经退行性变, 肢带型肌营养不良, 肢带型肌营养不良2A亚型, 肢带型肌营养不良2B亚型, 肢带型肌营养不良1C亚型, 肢带型肌营养不良2D亚型, 钙激活酶3, α-肌聚糖, dysferlin, caveolin3, 基金资助文章

Abstract:

The relative frequencies of different subtypes of limb-girdle muscular dystrophies vary widely among different populations. We estimated the percentage of limb-girdle muscular dystrophy sub-types in Chinese people based on 68 patients with limb-girdle muscular dystrophy from the Myology Clinic, Neurology Department, First Hospital of Jilin University, China. A diagnosis of calpainopathy was made in 12 cases (17%), and dysferlin deficiency in 10 cases (15%). Two biopsies revealed α-sarcoglycan deficiency (3%), and two others revealed a lack of caveolin-3 (3%). A diagnosis of unclassified limb-girdle muscular dystrophy was made in the remaining patients (62%). The ap-pearances of calpain 3- and dysferlin-deficient biopsies were similar, though rimmed vacuoles were unique to dysferlinopathy, while inflammatory infiltrates were present in both these limb-girdle muscular dystrophy type 2D biopsies. Macrophages were detected in seven dysferlinopathy biop-sies. The results of this study suggest that the distribution of limb-girdle muscular dystrophy sub-types in the Han Chinese population is similar to that reported in the West. The less necrotic, re-generating and inflammatory appearance of limb-girdle muscular dystrophy type 2A, but with more lobulated fibers, supports the idea that calpainopathy is a less active, but more chronic disease than dysferlinopathy. Unusual features indicated an extended limb-girdle muscular dystrophy disease spectrum. The use of acid phosphatase stain should be considered in suspected dysferlinopathies. To the best of our knowledge, this is the first report to define the relative proportions of the various forms of limb-girdle muscular dystrophy in China, based on protein testing.