专家笔谈
ENGLISH ABSTRACT
遗传咨询在我国口腔医学领域的应用现状与展望
段小红
作者及单位信息
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DOI: 10.3760/cma.j.cn112144-20230422-00169
Application status and prospect of genetic counseling in stomatology in China
Duan Xiaohong
Authors Info & Affiliations
Duan Xiaohong
Clinic of Oral Rare Diseases and Genetic Diseases & Department of Oral Biology, School of Stomatology, The Fourth Military Medical University, State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Xi′an 710032, China
·
DOI: 10.3760/cma.j.cn112144-20230422-00169
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摘要

口腔遗传病与罕见病是一类特殊的口腔疾病,其患病率低、临床特征复杂、病情较重,该类疾病除了常规口腔诊治外,还应开展包括遗传咨询在内的多学科诊治。本文回顾了遗传咨询的基本内容,目前我国口腔领域遗传咨询的应用现状以及面临的问题,如缺乏开展遗传咨询的人员和遗传咨询知识普及程度不高等。同时,笔者对未来如何促进遗传咨询在口腔领域的应用,提出应开展口腔医师的遗传培训、促进医学遗传学知识与口腔知识的融合以及学科合作、加强口腔疾病遗传咨询的规范化建设等。

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口腔遗传病与罕见病是一类特殊的口腔疾病,其患病率低、临床特征复杂、病情较重,该类疾病除了常规口腔诊治外,还应开展包括遗传咨询在内的多学科诊治。本文回顾了遗传咨询的基本内容,目前我国口腔领域遗传咨询的应用现状以及面临的问题,如缺乏开展遗传咨询的人员和遗传咨询知识普及程度不高等。同时,笔者对未来如何促进遗传咨询在口腔领域的应用,提出应开展口腔医师的遗传培训、促进医学遗传学知识与口腔知识的融合以及学科合作、加强口腔疾病遗传咨询的规范化建设等。
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遗传咨询;遗传性疾病;罕见病;口腔医学;颅颌面
ABSTRACT

Oral genetic diseases and rare diseases are special oral diseases with low prevalence, complex clinical characteristics and serious condition. In addition to regular oral diagnosis and treatment, multidisciplinary diagnosis and treatment including genetic counseling should also be carried out for such diseases. This article reviews the basic content of genetic counseling, the current application status of genetic counseling in the field of stomatology in China and the problems faced, such as the lack of genetic counseling personnel and the popularization of genetic counseling knowledge. Aims to promote the application of genetic counseling in dental practice in the future, it is proposed to carry out genetic training for stomatologists, promote the integration of medical genetic expertise and oral knowledge, as well as discipline cooperation, and strengthen the standardization of genetic counseling for oral diseases.

Genetic counseling;Genetic diseases;Rare diseases;Oral medicine;Craniofacial
Duan Xiaohong, Email: nc.defudabe.ummfnaudhx, Tel: 0086-29-84776169
引用本文

段小红. 遗传咨询在我国口腔医学领域的应用现状与展望[J]. 中华口腔医学杂志,2023,58(08):759-765.

DOI:10.3760/cma.j.cn112144-20230422-00169

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不同的组织和学会针对遗传咨询(genetic counseling)的定义不尽相同,综合解读国家卫生健康委员会住院医师规范化培训规划教材《医学遗传学》、美国人类遗传协会(American Society of Human Genetics,ASHG)和其他遗传咨询协会(National Society of Genetic Counselors,NSGC)关于遗传咨询的定义 1 , 2 , 3,遗传咨询是遗传专业人员(遗传咨询师、临床遗传学家等)通过与咨询者交流,帮助其理解疾病发生和发展中的遗传因素相关信息,进而使其适应疾病对医疗、心理和家庭的影响。简而言之,遗传咨询是帮助咨询者了解所患疾病的遗传病因、诊断、治疗、预防及预后等相关知识和信息。
随着医学遗传学技术的发展和遗传病知识的不断丰富,遗传咨询在公众生活中的作用逐渐被重视,如越来越多有生育需求的人进行遗传病筛查和遗传咨询。此外,遗传因素与一些复杂疾病如糖尿病、高血压及肿瘤等的关系备受关注,很多患者也有对应的咨询需求,使得遗传咨询的目的不再仅仅局限于以往的出生缺陷干预等,其疾病范畴更广泛,内容更复杂多样,口腔领域也不例外 4 , 5
在口腔临床实践中,遗传咨询的需求也逐渐增多。患者不仅向口腔临床医师咨询一些重大颅颌面口腔畸形的危害,也可能对一些颅颌面口腔的轻度畸形和功能障碍的患病风险进行咨询,包括但不限于这些异常对患者及其家属的危害、再发风险等,这些问题对常规口腔临床实践提出了挑战。作为口腔临床医师如何回答这些问题,是否能对此类疾病进行遗传咨询,以何种方式开展以及遗传咨询的内容等,均成为传统口腔临床医学面临的新问题 4 , 5
本文简要介绍遗传咨询的定义、对象和咨询过程等内容,总结遗传咨询在口腔医学领域的临床应用及其在该领域的特殊性,分析遗传咨询的现状和存在的问题,展望遗传咨询在口腔医学领域未来的发展方向。
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备注信息
A
段小红,Email: nc.defudabe.ummfnaudhx,电话:029-84776169
B
段小红. 遗传咨询在我国口腔医学领域的应用现状与展望[J]. 中华口腔医学杂志, 2023, 58(8): 759-765. DOI: 10.3760/cma.j.cn112144-20230422-00169.
C
作者声明不存在利益冲突
D
国家自然科学基金 (81974145,81771052)
陕西省重点研发计划 (2021ZDLSF02-13)
国家口腔疾病临床医学研究中心专项课题 (LCA202013)
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