肖康, 周伟, 张宝云, 陈操, 董小平, 石琦. 2014年中国克雅氏病监测网络病例特征分析[J]. 疾病监测, 2016, 31(1): 18-23. DOI: 10.3784/j.issn.1003-9961.2016.01.006
引用本文: 肖康, 周伟, 张宝云, 陈操, 董小平, 石琦. 2014年中国克雅氏病监测网络病例特征分析[J]. 疾病监测, 2016, 31(1): 18-23. DOI: 10.3784/j.issn.1003-9961.2016.01.006
XIAO Kang, ZHOU Wei, ZHANG Bao-yun, CHEN Cao, DONG Xiao-ping, SHI Qi. Characteristics of Creutzfeldt-Jakob disease cases in China, 2014[J]. Disease Surveillance, 2016, 31(1): 18-23. DOI: 10.3784/j.issn.1003-9961.2016.01.006
Citation: XIAO Kang, ZHOU Wei, ZHANG Bao-yun, CHEN Cao, DONG Xiao-ping, SHI Qi. Characteristics of Creutzfeldt-Jakob disease cases in China, 2014[J]. Disease Surveillance, 2016, 31(1): 18-23. DOI: 10.3784/j.issn.1003-9961.2016.01.006

2014年中国克雅氏病监测网络病例特征分析

Characteristics of Creutzfeldt-Jakob disease cases in China, 2014

  • 摘要: 目的 了解中国12个克雅氏病(creutzfeldt-Jakob disease, CJD)监测网络省(直辖市、自治区)克雅氏病的发病情况、流行病学及临床特征。方法 对2014年我国克雅氏病监测网络获得的可疑克雅氏病病例的临床及流行病学资料进行分析, 收集患者脑脊液及血液样品, 利用Western blot方法检测脑脊液中14-3-3蛋白, 提取全血基因组DNA并利用PCR及测序方法对PRNP基因进行129位和219位氨基酸多态性及基因突变的分析。结果 发现散发型克雅氏病临床诊断病例143例(44.14%), 疑似诊断病例15例(4.63%), 遗传型克雅氏病病例10例(3.09%), 致死性家族型失眠症8 例(2.47%)。病例报告无季节聚集性, 长久居住地呈散在分布, 职业分布广泛。临床诊断病例年龄中位数为61岁(24, 81), 男女性别比为1.07:1;疑似诊断病例年龄中位数为57岁(33, 76), 男女性别比为1.5:1。快速进行性痴呆为最常见的首发症状。脑脊液14-3-3蛋白、脑电图(EEG)以及头颅磁共振成像(MRI) 三项检测结果中, 出现阳性结果越多的病例表现出更多的典型症状。对324份血液样品PRNP基因的检测, 其中297例129位氨基酸为M/M纯合子, 294例219位氨基酸为E/E纯合子。结论 2014年我国监测到的克雅氏病病例的报告时间、长久居住地、职业、性别比例以及年龄分布均符合散发型克雅氏病的发病特点。

     

    Abstract: Objective To understand the epidemiological and clinical characteristics of the patients with Creutzfeldt-Jakob disease (CJD) in 12 provinces in China. Methods The clinical and epidemiological data of CJD patients obtained from China CJD surveillance network were analyzed. Blood and cerebral spinal fluid (CSF) specimens were collected from these patients. Western blot assay was conducted for detecting 14-3-3 protein in CSF, and PCR and sequencing were performed for analyzing the polymorphism of 129 and 219 amino acid and mutation of PRNP gene. Results A total of 143 probable CJD cases (44.14%) and 15 possible CJD cases (4.63%), 10 genetic CJD cases (3.09%) and 8 fatal familial insomnia (FFI) cases (2.47%) were identified. The cases occurred sporadically without clustering in time, place and population distributions. The median age of probable CJD cases was 61 years (24, 81), the ratio of male to female was 1.07:1. The median age of possible CJD cases was 57 years (33, 76), the ratio of male to female was 1.5:1. Rapidly progressive dementia was the major initial symptom. The probable CJD cases with more positive results in EEG, MRI and detection of 14-3-3 protein in CSF showed more typical clinical symptoms. Among 324 cases, 297 were M/M in allele 129, and 294 were E/E in allele 219. Conclusion CJD occurred sporadically in China in 2014. The time, place and population distributions, gender ratio and the average onset age of the CJD cases were consistent with the general characteristics of sporadic CJD cases in the world.

     

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