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目的:探讨n ASNS基因变异致天冬酰胺合成酶缺乏症的临床特点和基因变异情况。n 方法:回顾性分析2018年10月至2020年2月青岛大学附属医院神经内分泌儿科收治的天冬酰胺合成酶缺乏症一家系的临床资料。应用全外显子分析技术对先证者进行致病变异筛查,结合先证者表型,确定候选基因的致病位点,应用Sanger测序对先证者、其父母及其他家系成员进行变异位点验证。查阅相关文献数据库,收集已报道的n ASNS突变病例并进行文献复习。n 结果:先证者,女,4月龄时就诊,3月龄左右出现反复惊厥发作,查体发现患儿小头畸形,智力、运动发育落后;视频脑电图检查为广泛性中-高波幅棘慢、尖形慢波。外显子测序发现n ASNS基因复合杂合变异:c.1211G>A(p.R404H)、c.1643C>T(p.S548F);c.1211G>A为已知致病变异,c.1643C>T为新变异,未见文献报道。先证者弟弟,2月龄时就诊,1月龄时出现抽搐,智力、运动发育落后;视频脑电图检查为双侧后头部为主多灶及广泛性棘波、棘慢波、快波发放。Sanger测序发现与先证者相同的n ASNS复合杂合变异。2例患儿均服用抗癫痫药物治疗无效,分别于7月龄及6月龄时死于惊厥持续状态。n 结论:本研究有助于对此疾病临床特征的进一步认识,同时发现1个n ASNS基因新的致病变异,丰富了n ASNS基因变异谱,为临床治疗和遗传咨询提供重要依据。n “,”Objective:To investigate the clinical characteristics and gene variation of asparagine synthase deficiency that is caused by n ASNS gene variation.n Methods:In Department of Neuroendocrine Pediatrics, Affiliated Hospital of Qingdao University from October 2018 to February 2020, the clinical data of a family of asparagine synthase deficiency were analyzed retrospectively.The pathogenic mutation of the proband was screened by the full exon analysis technique.The pathogenic sites of candidate genes were determined by combining the phenotype of the proband.In the heterotopic spot of the proband, his parents and other family members were verified by Sanger sequencing.Meanwhile, the relevant literature database was consulted, and the reported n ASNS mutation related cases were collected and reviewed.n Results:The female with proband visited the hospital at the age of 4 months, and she had recurrent convulsions at the age of about 3 months.Physical examination showed that the child suffered from microcephaly, and mental and motor retardation.Meanwhile, video electroencephalogram examination displayed extensive moderate high amplitude spiny slow wave and sharp slow wave.Exon sequencing illustrated that the compound heterozygous variants of n ASNS gene were c. 1211G>A (p.R404H) and c. 1643C>T (p.S548F), respectively.c.1211G>A was a known pathogenic variant, and c. 1643C>T was a new variant.The proband′s younger brother visited the hospital at the age of 2 months, developed convulsions at the age of 1 month, and developed mental and motor retardation.Electroencephalogram displayed that bilateral posterior head was dominant, multiple foci and extensive spike wave, and spike slow wave and fast wave were distributed.Sanger sequencing revealed the samen ASNS compound heterozygous variants as the proband.Both of them died of status convulsion at the age of 7 months and 6 months, respectively.n Conclusions:This study is helpful to further understand the clinical features of the disease and reveal a new pathogenic mutation of n ASNS gene, so as to enrich the mutation spectrum of n ASNS gene, thus providing important basis for clinical treatment and genetic counseling.n