自然流产胚胎染色体数目异常的临床研究

目的:探讨染色体数目异常与自然流产的关系及其影响因素。方法:采用荧光原位杂交技术对100例早期妊娠自然流产绒毛进行染色体数目检测,分析其与自然流产的关系。结果:100例绒毛标本中,染色体数目异常42例,占42.00%;嵌合体16例,占16.00%。最常见的染色体异常是三倍体,占35.71%;其次为45,X和16三体,分别占16.67%和14.29%。高龄组(≥35岁)和非高龄组(<35岁)异常染色体检出率分别为45.46%(10/22)和41.03%(32/78),差异无统计学意义(P>0.05);有自然流产史和无自然流产史者异常染色体检出率分别为42.55%(20/47)和41.51%(22/53),差异无统计学意义(P>0.05);妊娠≤10周和妊娠>10周者染色体异常率分别为45.00%(27/60)和37.50%(15/40),差异无统计学意义(P>0.05)。结论:染色体异常是早期自然流产最主要的原因,无论孕母年龄大小、既往有无自然流产史及无论孕周大小,本次发生自然流产者均有可能与染色体异常有关。临床医师应重视染色体的检查,以便为再次妊娠做好遗传咨询指导。

Clinical research on chromosomal numerical abnormality in embryos of spontaneous abortion

Objective:To explore the relationship between chromosomal numerical abnormality and spontaneous abortion,analyze the influencing factors of spontaneous abortion. Methods:Fluorescent in situ hybridization technique was used to detect the chromosomal number in chorionic villus of one hundred cases with early spontaneous abortion,then the relationship between chromosomal number and spontaneous abortion was analyzed. Results:Among 100 cases,42 cases were found with chromosomal numerical abnormality,accounting for 42.00%;16 cases were found with chimera,accounting for 16.00%.The most common chromosomal abnormality was triploid,accounting for 35.71%,followed by 45,X and trisomy 16,accounting for 16.67% and 14.29%,respectively.The detection rate of chromosomal abnormality in advanced age group(≥35 years) was 45.46%(10/22),while the detection rate of chromosomal abnormality in non-advanced age group(<35 years) was 41.03%(32/78),there was no significant difference(P>0.05).The detection rate of chromosomal abnormality in the cases with history of spontaneous abortion was 42.55%(20/47),while the detection rate of chromosomal abnormality in the cases without history of spontaneous abortion was 41.51%(22/53),there was no significant difference(P>0.05).The detection rate of chromosomal abnormality in the cases of ≤10 gestational weeks was 45.00%(27/60),while the detection rate of chromosomal abnormality in the cases of>10 gestational weeks was 37.50%(15/40),there was no significant difference(P>0.05). Conclusion:Chromosomal abnormality is the main cause of early spontaneous abortion,regardless of maternal age,previous history of spontaneous abortion or not,and gestational weeks,the cases with spontaneous abortion at this time may be associated with chromosomal abnormality.Clinicians should pay more attention to chromosomal examination,in order to provide genetic counseling for subsequent pregnancy.