在以色列进行神经发育障碍的遗传测试
Dalit May1,2,3, Ruth Barshir4, Moni Shahar4
1Clalit Health Services, Jerusalem, Israel.
JAMA network open
|August 19, 2025
概括
神经发育障碍 (NDD) 的遗传咨询和测试率很低,特别是在少数群体中. 许多接受遗传咨询的患者没有接受测试,突出了获取和认识差距.
科学领域:
- 医学遗传学 医学遗传学
- 儿科 儿科 儿科
- 公共卫生 公共卫生
背景情况:
- 基因检测,包括染色体微阵列分析 (CMA),对于诊断神经发育障碍 (NDD),如自闭症和智力障碍至关重要.
- 尽管取得了进展,但在NDD中进行基因测试的临床使用数据仍然有限.
- 了解遗传咨询和检测率对于改善诊断途径至关重要.
研究的目的:
- 评估被诊断患有主要神经发育障碍 (NDD) 的患者的遗传咨询和测试率.
- 分析与遗传咨询和测试吸收相关的临床和社会人口统计特征.
- 确定NDD患者获得遗传服务的差异.
主要方法:
- 一个纵向,回顾性,基于人口的队列研究,使用来自以色列克莱利特卫生服务的电子健康记录.
- 分析包括2000年至2020年之间出生的被诊断患有主要NDD (自闭症,智力障碍,全球发育迟缓,,脑) 的个人.
- 测量结果包括遗传咨询,CMA测试和NDD诊断的比率.
主要成果:
- 在25403名患有重大NDD的个体中,只有38.7%接受了遗传咨询,24.5%接受了CMA测试.
- 与自闭症单独 (21.2%) 相比,多个同时发生的NDD (36.9%) 的基因测试率更高.
- 在较低的社会经济地位和少数群体中,自闭症诊断率明显较低 (54%-83%),影响了获得遗传服务的机会.
结论:
- 很大一部分被转诊接受遗传咨询的患者没有进行测试.
- 在自闭症诊断和低社会经济地位和少数群体获得遗传服务方面存在显著差异.
- 需要国家倡议来提高对所有NDDs的遗传咨询和测试的认识和平等获取.
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