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论著·临床研究 | 更新时间:2025-06-03
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8例Silver⁃Russell综合征患儿的临床表型与遗传学分析
Analysis of clinical phenotype and genetics in 8 children with Silver⁃Russell syndrome

广西医学 页码:554-558

作者机构:覃海兰,在读硕士研究生,研究方向为儿科遗传疾病研究。

基金信息:国家自然科学基金(82160315);广西自然科学基金(2021GXNSFAA196047)

DOI:10.11675/j.issn.0253⁃4304.2025.04.11

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目的 总结Silver⁃Russell综合征(SRS)患儿的临床表型与遗传学特点。方法 分析8例SRS患儿的临床资料,包括基本信息、临床表型和治疗情况等。采集SRS患儿外周血并提取DNA后,采用甲基化特异性多重连接探针扩增法(MS⁃MLPA)检测SRS患儿11号染色体p15(11p15)区域和7号染色体的单亲二体(UPD)拷贝数变异与甲基化水平。结果 8例SRS患儿均表现为身材矮小和特殊面容(三角形脸多见),其中5例有足月小样儿出生史,6例肢体不对称。MS⁃MLPA检测结果提示,7例为11p15的印迹控制区1(ICR1)低甲基化,1例为7号染色体的母源性单亲二倍体[UPD(7)mat]。在11p15 ICR1低甲基化的患儿中,甲基化水平越低,患儿的身材矮小越严重;UPD(7)mat患儿存在严重的身材矮小。3例接受重组人生长激素治疗的患儿身高均较前得到改善。结论 SRS的诊断主要依靠严重的身材矮小、足月小样儿、三角脸、肢体不对称等临床表型。MS⁃MLPA检测可以明确大部分SRS患儿的病因,并可以根据甲基化水平程度,进一步指导治疗和预后评估。

Objective To summarize the clinical phenotype and genetics characteristics in children with Silver⁃Russell syndrome (SRS). Methods The clinical data of 8 children with SRS were analyzed, including basic information, clinical phenotype and treatment situation, etc. DNA was extracted from peripheral blood of children with SRS. Copy number variation and methylation level of chromosome 11p15 (11p15) and uniparental disomy (UPD) of chromosome 7 in SRS children were detected by methylation⁃specific multiplex ligation⁃dependent probe amplification (MS⁃MLPA). Results Eight SRS children presented as short stature and special facial features (triangular faces were more common), of which 5 cases had a history of small for gestational age infants, and 6 cases had limb asymmetry. MS⁃MLPA detection results suggested that 7 cases were hypomethylated imprinting control region 1 (ICR1) of 11p15, and 1 case was maternal UPD of chromosome 7 (UPD [7] mat). In children with 11p15 ICR1 hypomethylation, the lower the methylation level was, the more severe the short stature of children would be. Children with UPD (7) mat had severe short stature. The height of 3 children treated with recombinant human growth hormone was improved compared with before. Conclusion The diagnosis of SRS mainly depends on the clinical phenotypes such as severe short stature, small for gestational age infants, triangular face, and limb asymmetry. MS⁃MLPA detection can clarify the etiology of most children with SRS, and further guide the treatment and prognosis evaluation according to the methylation level.

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