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药物治疗儿童肝豆状核变性肝功能失代偿的效果观察

李春霞 龚敬宇 张梅虹 王建设

引用本文:
Citation:

药物治疗儿童肝豆状核变性肝功能失代偿的效果观察

DOI: 10.3969/j.issn.1001-5256.2017.08.027
详细信息
  • 中图分类号: R742.4

Effect of pharmacotherapy on decompensated liver function in children with hepatolenticular degeneration

  • 摘要:

    目的观察药物治疗对以肝功能失代偿起病的肝豆状核变性患儿的影响。方法收集2015年8月1日-2016年8月1日复旦大学附属金山医院收治的以"肝硬化,肝功能失代偿"起病的肝豆状核变性患儿3例,均经过ATP7B基因测序进一步确诊。所有患儿入院后立即给予低铜饮食和对症支持治疗,在明确肝豆状核变性的临床诊断后给予青霉胺和葡萄糖酸锌片联合治疗。记录患儿临床转归情况。结果 3例患儿均检测到ATP7B基因复合杂合突变。经内科综合治疗后,患儿低蛋白血症和凝血功能逐步改善,其中2例患儿Child-Pugh评分均有所降低。结论对于不明原因肝功能异常甚至肝硬化患儿,诊断需常规考虑肝豆状核变性,早期诊断、及时恰当的药物治疗可减少肝移植手术需求。

     

  • [1]SCHEINBERG IH, STERNLIEB I.Wilson disease and idiopathic copper toxicosis[J].Am J Clin Nutr, 1996, 63 (5) :842s-845s.
    [2]CACA K, FERENCI P, KHN HJ, et al.High prevalence of the H1069Q mutation in East German patients with Wilson disease:rapid detection of mutations by limited sequencing and phenotypegenotype analysis[J].J Hepatol, 2001, 35 (5) :575-581.
    [3]COMPSTON A.Progressive lenticular degeneration:a familial nervous disease associated with cirrhosis of the liver, by S.A.Kinnier Wilson, (From the National Hospital, and the Laboratory of the National Hospital, Queen Square, London) Brain 1912:34;295-509[J].Brain, 2009, 132 (Pt 8) :1997-2001.
    [4]CUMINGS JN.The cerebrospinal fluid in poliomyelitis[J].Overseas Postgrad Med J, 1949, 3 (10) :163.
    [5]DEHGHANI SM, IMANIEH MH, HAGHIGHAT M, et al.Etiology and complications of liver cirrhosis in children:report of a single center from southern iran[J].Middle East J Dig Dis, 2013, 5 (1) :41-46.
    [6]THOMAS GR, FORBES JR, ROBERTS EA, et al.The Wilson disease gene:spectrum of mutations and their consequences[J].Nat Genet, 1995, 9 (2) :210-217.
    [7]ZALI N, MOHEBBI SR, ESTEGHAMAT S, et al.Prevalence of ATP7B gene mutations in Iranian patients with Wilson disease[J].Hepat Mon, 2011, 11 (11) :890-894.
    [8]YANG J, CHAN P.Gene symbol:ATP7B.Disease:Wilson's disease[J].Hum Genet, 2005, 118 (3-4) :544.
    [9]SQUITTI R, SIOTTO M, BUCOSSI S, et al.In silico investigation of the ATP7B gene:insights from functional prediction of non-synonymous substitution to protein structure[J].Biometals, 2014, 27 (1) :53-64.
    [10]SCHUSHAN M, BHATTACHARJEE A, BEN-TAL N, et al.A structural model of the copper ATPase ATP7B to facilitate analysis of Wilson disease-causing mutations and studies of the transport mechanism[J].2012, 4 (7) :669-678.
    [11]ZHU M, NI W, DONG Y, et al.EGFP tags affect cellular localization of ATP7B mutants[J].CNS Neurosci Ther, 2013, 19 (5) :346-351.
    [12] Professional Study Group on Parkinson's Disease and Movement Disorders, Professional Study Group on Neurogenetic Diseases, Neurology Branch of Chinese Medical Association.Guidelines for the diagnosis and treatment of hepatolenticular degeneration[C]//Neurology Branch of Chinese Medical Association.Collected Papers from the11th National Conference of Neurology.Changchun, 2008:5. (in Chinese) 中华医学会神经病学分会帕金森病及运动障碍疾病专业学组、神经遗传疾病专业学组.肝豆状核变性诊断与治疗指南[C]//中华医学会神经病学分会.第十一届全国神经病学学术会议论文汇编.长春, 2008:5.
    [13] Liver Failure and Artificial Liver Group, Chinese Society of Infectious Diseases, CMA;Severe Liver Diseases and Artificial Liver Group, Chinese Society of Hepatology, CMA.Guideline for diagnosis and treatment of liver failure (2012 version) [J].Chin J Clin Infect Dis, 2012, 5 (6) :321-327. (in Chinese) 中华医学会感染病学分会肝衰竭与人工肝学组, 中华医学会肝病学分会重型肝病与人工肝学组.肝衰竭诊治指南 (2012年版) [J].中华临床感染病杂志, 2012, 5 (6) :321-327.
    [14]KUCINSKAS L, JEROCH J, VITKAUSKIENE A, et al.High frequency of the c.3207C>A (p.H1069Q) mutation in ATP7B gene of Lithuanian patients with hepatic presentation of Wilson's disease[J].World J Gastroenterol, 2008, 14 (38) :5876-5879.
    [15]DONG QY, WU ZY.Advance in the pathogenesis and treatment of Wilson disease[J].Transl Neurodegener, 2012, 1 (1) :23.
    [16]WU F, WANG J, PU C, et al.Wilson's disease:a comprehensive review of the molecular mechanisms[J].Int J Mol Sci, 2015, 16 (3) :6419-6431.
    [17]ROBERTS EA, ROBINSON BH, YANG S.Mitochondrial structure and function in the untreated Jackson toxic milk (tx-j) mouse, a model for Wilson disease[J].Mol Genet Metab, 2008, 93 (1) :54-65.
    [18]SAUER SW, MERLE U, OPP S, et al.Severe dysfunction of respiratory chain and cholesterol metabolism in Atp7b (-/-) mice as a model for Wilson disease[J].Biochim Biophys Acta, 2011, 1812 (12) :1607-1615.
    [19]MUFTI AR, BURSTEIN E, CSOMOS RA, et al.XIAP is a copper binding protein deregulated in Wilson's disease and other copper toxicosis disorders[J].Mol Cell, 2006, 21 (6) :775-785.
    [20]HAYASHI H, YANO M, FUJITA Y, et al.Compound overload of copper and iron in patients with Wilson's disease[J].Med Mol Morphol, 2006, 39 (3) :121-126.
    [21]MERLE U, TUMA S, HERRMANN T, et al.Evidence for a critical role of ceruloplasmin oxidase activity in iron metabolism of Wilson disease gene knockout mice[J].J Gastroenterol Hepatol, 2010, 25 (6) :1144-1150.
    [22]European Association for Study of Liver.EASL Clinical Practice Guidelines:Wilson's disease[J].J Hepatol, 2012, 56 (3) :671-685.
    [23]BURKHEAD JL, GRAY LW, LUTSENKO S.Systems biology approach to Wilson's disease[J].Biometals, 2011, 24 (3) :455-466.
    [24]BENNETT J, HAHN SH.Clinical molecular diagnosis of Wilson disease[J].Semin Liver Dis, 2011, 31 (3) :233-238.
    [25]BENNETT JT, SCHWARZ KB, SWANSON PD, et al.An exceptional family with three consecutive generations affected by Wilson disease[J].JIMD Rep, 2013, 10:1-4.
    [26]NAKAYAMA K, KUBOTA M, KATOH Y, et al.Early and presymptomatic detection of Wilson's disease at the mandatory 3-year-old medical health care examination in Hokkaido Prefecture with the use of a novel automated urinary ceruloplasmin assay[J].Mol Genet Metab, 2008, 94 (3) :363-367.
    [27]ALA A, BORJIGIN J, ROCHWARGER A, et al.Wilson disease in septuagenarian siblings:raising the bar for diagnosis[J].Hepatology, 2005, 41 (3) :668-670.
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  • 收稿日期:  2017-01-13
  • 出版日期:  2017-08-20
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