高龄孕妇胎儿颈项透明层、染色体核型及妊娠结局分析  

Analysis of fetal nuchal translucency,chromosomal karyotype and pregnancy outcome in pregnant women with advanced age

作　　者：钟刚 龙湘党[1] 姚穗[1] 邓利[1] 刘艳[1] 李巧荣 Zhong Gang;Long Xiang-dang;Yao Sui;Deng li;Liu Yan;Li Qiao-rong(The First Affiliated Hospital of Human Normal University/Hunan Provincial People’s Hospital,Changsha 410005,China)

机构地区：[1]湖南师范大学附属第一医院/湖南省人民医院,长沙410005

出　　处：《湖南师范大学学报（医学版）》2021年第2期45-47,共3页Journal of Hunan Normal University(Medical Sciences)

基　　金：湖南省临床医疗技术创新引导项目(No.2018SK50706)。

摘　　要：目的:探讨高龄孕妇胎儿颈项透明层(NT)、染色体核型检测的临床意义。方法:选取在湖南师范大学附属第一医院行孕11~13^(+6)周超声检查同时进行了羊膜腔穿刺术检查的单胎高龄孕妇396例作为研究对象,以NT≥2.5 mm为截断点将高龄孕妇分为NT增厚组和NT正常组,随访妊娠结局,分析高龄孕妇胎儿异常染色体核型分布情况,并将≥40岁孕妇组与<40岁孕妇组进行比较,采用SPSS 23.0统计软件分析数据。结果:396例高龄孕妇中,胎儿NT增厚24例,发生率6.06%。NT增厚组胎儿不良妊娠结局、染色体异常和结构畸形发生率显著高于NT正常组;染色体异常发生率8.58%(34/396),包括染色体数目异常21例,染色体结构异常11例,嵌合体2例,以染色体数目异常发生率最高(5.30%,21/396),以21-三体最常见(2.52%,10/396);≥40岁孕妇组21-三体发生率显著高于<40岁孕妇组。结论:高龄孕妇胎儿的NT检查和染色体核型检测可有效降低染色体异常和结构畸形胎儿的出生。Objective To explore the clinical significance of fetal nuchal translucency(NT)and chromosomal karyotype detection in pregnant women with advanced age.Methods 396 singleton pregnant women with advanced age(≥35 years old)who underwent amniocentesis and ultrasonography at 11-13^(+6)weeks of pregnancy in the First Affiliated Hospital of Hunan Normal University were selected as the object of study.The pregnant women were divided into NT thickening group and normal NT group with NT ≥2.5 mm as cutoff point,and the pregnancy outcome was followed up.The abnormal chromosomal karyotype distribution of fetus was analyzed,and the differences between ≥40 years old pregnant women and<40 years old pregnant women were compared.All data was analysed by SPSS 23.0 statistical software.Results Among the 396 pregnant women with advanced age,24 cases of fetal NT thickened,with an incidence of 6.06%.The incidences of adverse pregnancy outcome,chromosomal abnormalities and fetal structural abnormalities in NT thickening group were significantly higher than those in normal NT group.The incidence of abnormal chromosomal karyotype was 8.58%(34/396),including 21 cases of chromosomal numeral abnormality,11 cases of chromosomal structural abnormality and 2 cases of chimerism.The incidence of chromosomal numeral abnormality was the highest(5.30%,21/396).Trisomy 21 syndrome was the most common(2.52%,10/396).The incidence of trisomy 21 syndrome in the ≥40-year-old pregnant group was significantly higher than that in the<40-year-old pregnant group.Conclusion Detection of NT and chromosomal karyotype of fetuses in pregnant women with advanced age can effectively reduce the birth rate of children with chromosomal abnormalities and structural malformations.

关 键 词：高龄 孕妇 颈项透明层 染色体 妊娠结局 

分 类 号：R714.5[医药卫生—妇产科学]