苯丙酮尿症治疗研究新进展

New advances in phenylketonuria therapy research

苯丙酮尿症是最常见的一组遗传代谢病,是由于苯丙氨酸代谢途径中酶缺陷导致,以血苯丙氨酸浓度增高为特点.苯丙酮尿症患儿一经诊断需早期、合理治疗,若未及时诊治,将出现严重的神经系统后遗症.治疗旨在降低血液苯丙氨酸浓度,减轻神经系统症状.目前主要治疗方法是严格限制饮食苯丙氨酸摄入量.由于患儿长期饮食限制治疗依从性差、家庭负担重,选择应用新的营养和药物治疗,如四氢生物喋呤辅助因子、糖巨肽、大量中性氨基酸等均能改善苯丙酮尿症患者的治疗效果及生活状态.此外,重组苯丙氨酸裂解酶、肝细胞移植、基因治疗、益生菌等新型治疗方法也为患者提供了治疗的新希望.

Phenylketonuria is a most common group of genetic metabolic diseases.Phenylketonuria is caused by enzymatic defects in the metabolic pathway,which is characterized by high blood phenylalanine concentration.Patients need early,reasonable treatment once diagnosis,otherwise there will be serious nervous system sequelae.Available treatments aim to decrease the blood phenylalanine concentration,reduce nervous system symptoms.The current primary treatment of phenylketonuria is the limitation of dietary phenylalanine intake.Considering the poor compliance with long-term eating restrictions and the heavy family burden,the application of new medicine such as trahydropterina cofactor,glycomacropeptide,large neutral amino acids can improve the therapeutic effect and living condition of phenylketonuria patients.In addition,recombinant phenylalanine ammonia lyase,hepatocyte transplantation,gene therapy,probiotics and other new treatments also seem to be a promising approach in the near future.