不同类型早期稽留流产的绒毛染色体分析  

Karyotype analysis on the chorionic villus in different types of early pregnancy loss

作　　者：聂庆文[1] 华芮[1] 周瑶[1] 李红[1] 

机构地区：[1]南方医科大学南方医院妇产科生殖中心

出　　处：《广东医学》2017年第23期3580-3583,共4页Guangdong Medical Journal

基　　金：国家科技支撑计划项目(编号:2013BAI12B01-7)

摘　　要：目的分析在早期稽留流产中有胎芽和无胎芽两种绒毛染色体的差异性。方法回顾性收集因早期流产行清宫术+胚胎绒毛染色体检查的患者431例,根据B超情况分为胎芽组和空囊组,有自然妊娠(NC)和IVF/ICSI妊娠(ART)两种不同来源。比较两组一般情况和染色体核型的组成差异。结果 431例样本中检出异常核型255例(59.2%),胎芽组染色体异常率显著高于空囊组(65.8%vs 47.1%,P=0.000),35岁以下更为明显;所有45,X和90%可存活三体(13、18、21-三体)存在胎芽组,空囊组最常见的异常核型为16、22-三体;年龄是非整倍体的危险因素,校正年龄后ART不增加非整倍体的发生风险,各组间流产物性别比差异无统计学意义。结论绒毛染色体异常和有胎芽流产密切相关,但可能不是无胎芽的主要原因,ART妊娠并不增加孕早期自然流产胚胎染色体异常的发生率。Objective To analysis the chromosomal karyotype of chorionic villus in early pregnancy loss with or without fetal pole. Methods A retrospective analysis was conducted from January 2012 to June 2016 in Nanfang Hospital of Southern Medical University. A total of 431 patients, who underwent dilation and curettage （D＆C） and cytogenetic tests for early pregnancy losses, were recruited. Embryonic and anembryonic pregnancy loss were diagnosed based on the presence or absence of an embryonic pole during transvaginal sonography, all cases derived from natural conception or in vitro fertilization and intracytoplasmic sperm injection （IVF/ICSI）. The composition of chromosomal in two groups were analyzed, as well as patient characteristics. Results Of the 431 samples from early spontaneous abortion, 255 cases （59. 2% ） were with abnormal karyotype. The frequency of aneuploidy in embryonic group was significantly higher than that in anembryonic group （65.8% versus 47. 1% , P =0. 000） , especially in women under 35 years old. All monosomy X and ninety percent viable autosomal trisomy （trisomy 13, 18 and 21 ） were observed in embryonic group, while trisomy （16 and 22） were mostly observed in anembryonic group. Advanced maternal age increased the risk of aneuploidy, but there was no significant difference between ART pregnancy and aneuploidy after adjustment. There was no statistically sig- nificant difference in abortus sex ratio. Conclusion Chromosomal anomaly is closely correlated to embryonic pregnancy, thouhg may not be the major reason of anembryonic pregnancy. Compared with natural conception, ART doesn＇t increase the rate of chorionic villus chromosome abnormality in spontaneous abortion during the first trimester.

关 键 词：早期稽留流产 染色体核型分析 无胎芽妊娠 

分 类 号：R714.21[医药卫生—妇产科学]