目的 探讨Kennedy病伴肌肉线粒体功能异常和戊二酸尿症Ⅱ型的临床特点. 方法 回顾性分析1例Kennedy病伴肌肉线粒体功能异常和戊二酸尿症Ⅱ型患者的临床资料. 结果 本例患者表现为四肢近端无力、肌束震颤、球麻痹、肌萎缩、姿势性震颤、感觉障碍、男性乳房发育、阳萎. 患者血肌酸激酶和尿戊二酸升高. EMG和神经肌肉活检支持混合性周围神经病变,骨骼肌神经源性和继发肌源性改变. X染色体CAG重复扩增47次. 患者发病7年后确诊为糖尿病. 结论 Kennedy病的发病机制十分复杂,肌源性因素可能参与其中. 对患者肌肉组织继发性线粒体和脂质代谢异常进行干预,一定程度上可改善肌无力症状.%Objective To investigate the clinical characteristics of Kennedy disease with secondary mitochondrial dysfunction and glutaric aciduria typeⅡ.Methods The clinical data of 1 case Kennedy disease with secondary mitochondrial dysfunction and glutaric aciduria typeⅡwas retrospectively analyzed.Results The patient presented muscle weakness in proximal limbs, fasciculation, bulbar palsy, amyotrophy, postural tremor, sensory disturbance, gynaecomastia, impotency.The level of serum creatine kinase and urinary glutaric acid were elevated. Electromyogram and nerve and muscle biopsy supported mixed damage in peripheral nerves, as well as neurogenic and secondary myogenic pathologic changes in muscles.Gene sequencing indicated trinucleotide CAG repeated amplification for 47 times in chromosome X.Diabetes was diagnosed at 7 years after onset.Conclusions The pathogenesis of Kennedy disease is very complex, which may involve myogenic factor.The treatment to the secondary mitochondrial and lipid metabolic disturbance in muscle can improve the muscle weakness to a certain extent.
展开▼
