我国胚胎植入前遗传学诊断技术配置和服务利用分析  

Configuration and service utilization analysis of preimplantation genetic diagnosis in China

作　　者：白符 马艺 高丽娜 张懿心 王冬颖 李志新 Bai Fu;Ma Yi;Gao Lina;Zhang Yixin;Wang Dongying;Li Zhixin(National Center for Women and Children's Health,NHC,Beijing 100081,China;The Medical Record Department of Tianjin Medical University Cancer Institute&Hospital,Tianjin 300060,China)

机构地区：[1]国家卫生健康委妇幼健康中心,北京100081 [2]天津医科大学肿瘤医院病案室,天津300060

出　　处：《中华生殖与避孕杂志》2024年第11期1180-1183,共4页Chinese Journal of Reproduction and Contraception

基　　金：国家重点研发计划(2023YFC2705503)。

摘　　要：目的分析我国胚胎植入前遗传学诊断(preimplantation genetic diagnosis,PGD)技术配置特征、服务利用趋势及服务效果。方法本研究采用纵向研究及2020年横断面调查数据分析的方法,研究2004—2020年我国具备PGD机构配置数量和服务利用趋势。从不同地域分布、城市定位、机构类别等描述2020年技术配置特征和服务效果。应用PGD治疗夫妇对数、取卵周期数和诊断周期数初步评价服务规模及特点。结果2004—2020年,PGD机构配置数量从2004年仅4家(10.8%)增至2020年的78家(19.0%)。PGD服务周期数量虽伴随增长,但总体占比不高,在0.3%~4.1%之间。2020年报告PGD诊断周期总数21241个,占取卵周期总数的4.1%。2020年PGD技术配置表现出以省会城市[82.1%(64/78)]、公立医院[94.9%(74/78)]、综合医院[59.0%(46/78)]为主的特征。东、中、西地区机构PGD取卵周期数中位数差异显著,分别为203.0、177.5和79.0。2020年PGD随访临床妊娠率为60.2%(10326/17158),分娩率为51.1%(8767/17158),多胎分娩率为1.9%(163/8767),活产婴儿数8904。结论PGD技术在我国经过20余年的快速发展,地理可及性显著改善。PGD服务规模较小,且存在不均衡性。技术配置以东、中部地区省会城市的综合医院为主要特点,地市级机构和西部地区机构也成为PGD技术的重要提供方。Objective:To analyze the configuration characteristics,service utilization trend and outcome of preimplantation genetic diagnosis(PGD)in China.Methods:A longitudinal study and a cross-sectional survey in 2020 were used to analyze the number of PGD facilities and the trend of service utilization in China from 2004 to 2020.The characteristics of 2020 technology configuration were described from different geographical distribution,city positioning,and organization categories.The number of couples treated,the number of egg retrieval cycles and the number of diagnostic cycles were used to evaluate the scale of the service.Results:From 2004 to 2020,the number of PGD institutions increased from only 4(10.8%)in 2004 to 78(19.0%)in 2020.Although the number of PGD cycles increased with it,the overall proportion was not high,ranging from 0.3%to 4.1%.A total of 21241 PGD cycles were reported in 2020,accounting for 4.1%of the total number of egg retrievals.The PGD technology configuration in 2020 was mainly characterized by provincial capitals[82.1%(64/78)],public hospitals[94.9%(74/78)],and comprehensive hospitals[59.0%(46/78)].There were significant differences in the median of the number of PGD egg retrieval cycles in eastern,central and western institutions,which were 203.0,177.5 and 79.0,respectively.In 2020,the PGD clinical pregnancy rate was 60.2%(10326/17158),the delivery rate was 51.1%(8767/17158),the multiple delivery rate was 1.9%(163/8767),totally with 8904 live births.Conclusion:After more than 20 years of rapid development of PGD technology in China,the geographical accessibility has been significantly improved.PGD services are small and uneven.Comprehensive hospitals in the capital cities of the eastern and central regions are the main features of the technical configuration,and prefecture-level institutions and institutions in the western regions have also become important providers of PGD technology.

关 键 词：植入前胚胎遗传学诊断 技术配置 服务利用 

分 类 号：R714.8[医药卫生—妇产科学]