目的 分析近亲婚配所致多巴反应性肌张力障碍( DRD)的GCH1基因突变特点.方法 对我院收治的3例同属一家系的DRD患者及其家系资料进行分析,对其家系进行遗传性运动障碍相关基因检测并验证.结果 该家系中,先证者父母(Ⅲ3与Ⅲ4)为近亲结婚.先证者(Ⅳ2)及其长女(Ⅴ2)、侄女(Ⅴ7)3例均为DRD患者,均为幼年发病,主要表现为帕金森病样症状和肌张力障碍,且均对多巴胺治疗反应良好,基因检测示GCH1基因存在c.245T＞C(p.Leu82Pro)突变.家系中先证者次女(Ⅴ3)、儿子(Ⅴ5)、外孙女(Ⅵ3)、弟弟(Ⅳ3)为异常基因携带者.结论 近亲婚配可增加DRD发病率.幼年起病的具有阳性家族史的肌张力障碍患者,应考虑DRD可能.基因检测是诊断DRD的有效手段.%Objective To analyze the characteristics of GCH1 gene mutation of close relatives marriage caused dopa reactive dystonia (DRD).Methods The data of 3 patients with DRD from the same family in our hospital and their families were analyzed.Genes related to hereditary dyskinesia in their families were detected and validated. Results In this family, the proband’s parents (Ⅲ3 and Ⅲ4) were close relatives.The proband (Ⅳ2) and her eldest daughter (Ⅴ2) and niece (Ⅴ7) were all DRD patients.All of them were young onset , mainly manifested as Parkinsonina-like symptoms and dystonia , and all responded well to dopamine therapy.Gene detection showed that the GCH1 gene had c.245T＞C (p.Leu82Pro) mutation.The second daughter (Ⅴ3), son (Ⅴ5), granddaughter (Ⅵ3) and brother (Ⅳ3) of the proband were carriers of abnormal genes.Conclusions Close relatives marriage increases the incidence of DRD.DRD may be considered in patients with a positive family history of dystonia.Gene detection is an effective diagnosis method.
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