血友病甲基因分析技术的改进及其在产前诊断中的应用

Improvement of gene analysis method in hemophilia A and its application of prenatal diagnosis

目的对血友病甲基因分析技术进行改进并应用于携带者检查和产前诊断。方法长距离聚合酶链反应方法直接检测凝血因子Ⅷ第22内含子倒位，对非倒位家系用FVH基因内限制酶切位点XbaI、HindⅢ、二核苷酸重复序列多态性位点STR13和STR22，以及基因外可变数目串联重复序列DXS52（St14）位点进行基因连锁分析。结果52个家系共检出71位携带者。21个家系为第22内含子倒位，28个家系经连锁分析得到明确诊断，3个家系无法诊断，可诊断家系占94．2％。为18个家系做胎儿产前诊断，其中10例诊断为血友病甲胎儿；诊断7例正常男胎和1例携带者女胎，随访1年发育正常。结论应用长距离聚合酶链反应和多位点基因连锁分析技术可以快速有效地进行血友病甲携带者检查和产前诊断。

Objective To establish a simple and rapid system for cartier detection and prenatal diagnosis in hemophila A （CHA） family. Methods Long distance-polymerase chain reaction （LD-PCR） was selected for detection factor Ⅷ intron 22 inversion. Polymorphism of factor Ⅷ intragenic restriction fragment length polymorphism （RFLP） of Xba I and Hind Ⅲ, short tandem repeat （STIR） within intron 13 and 22, as well as extragenic DXS52（ST 14） variable number of tandem repeat （VNTR） were assayed by PCR and linkage analysis. Results Seventy-one females were diagnosed as carriers within 52 HA famihes. Twenty-one famihes were diagnosed to be factor Ⅷ intron 22 inversion and 28 families were diagnosed by hnkage analysis, whereas 3 famihes could not been diagnosed. Seventeen of 18 fetuses at risk were male. Ten of 17 male fetuses were shown to be affected and were subsequently aborted. Seven male fetuses were diagnosed to be not affected. One female fetus was identified to be HA carrier. One-year follow-up study demonstrated that these babies were normal and living well. Conclusion LD-PCR combined with multiple locus linkage analysis enables the direct and indirect detection of HA for carrier testing and prenatal diagnosis.