不同超滤技术的临床应用

目的 :探讨心肺转流 (CPB)中应用不同超滤技术的适应证、最佳血液循环路径、技术实施要点及注意事项。方法 :回顾性总结、分析了 36 4例在CPB中应用常规超滤 (CUF)、改良超滤 (MUF)和零平衡超滤 (Z BUF)的临床资料。比较滤液量、超滤前后的血球压积 (Hct)、血钾浓度。结果 :CUF组滤液量 (110 9± 781)ml,超滤前Hct0 .2 4 8± 0 .0 4 9,超滤后Hct 0 .32 0± 0 .0 6 7。MUF组滤液量 (2 8.4± 12 .8)ml/kg ,超滤前Hct 0 .2 19± 0 .0 4 0 ,超滤后Hct 0 .335± 0 .0 76 ,随着血液浓缩 ,动脉压逐步上升 ,术后气管插管留置时间明显缩短。Z BUF组滤液量 (2 0 6 0±86 0 )ml,超滤前血钾 (6 .6 9± 0 .4 6 )mmol/L ,超滤后血钾 (5 .32± 0 .38)mmol/L。本组有 36例在停止CPB时液体出入量相等或负平衡 ,最多者 - 93ml/kg。术前有贫血 (Hb≤ 10 0 g/L)的 9例在停止CPB时Hb均恢复或略高于术前水平。体重≤ 10 的婴幼儿仅在MUF中输注 10 0～ 15 0ml的红细胞悬浮液。结论 :CUF和MUF都能够滤除人工心肺系统中多余的水分 ,浓缩血液 ,减少因输注血液制品所带来的并发症。MUF在清除体内、外多余水分的同时还能改善术后早期血流动力学和器官功能。目前 ,MUF已成为我所婴幼儿CPB所必需。Z BUF是治疗高血钾的有效措施之一     

超滤在小儿体外循环中的应用

目的:总结小儿先天性心脏病(CHD)患儿体外循环(CPB)中进行超滤的临床经验。方法:2000年1月～2006年12月我院共进行小儿CHD心内直视手术275例,其中重症及复杂畸形62例,均在手术中进行了超滤。超滤方法包括常规超滤(CUF)、改良超滤(MUF)。结果:62例患儿均未发现与超滤有关的并发症。采用CUF41例,MUF21例。两种超滤方法时间分别为(12.25±5.50)min、(11.35±2.38)min;分别滤出液体(312±25)ml和(510±15)ml。全组患者术中红细胞压积(HCT)(0.215±0.026)L/L,CUF结束时HCT(0.261±0.025)L/L,MUF结束时HCT(0.35±0.034)L/L。MUF在浓缩血液的同时也降低了炎症因子的浓度。结论:超滤能够滤出炎性介质等有害物质。CUF和MUF都可浓缩血液,MUF还具有迅速滤出体内多余水分,促进各脏器功能恢复的效果。     

低体重危重先心病婴儿的体外循环方法

目的　回顾 15 5例体重在 5kg以下危重先天性心脏病婴儿体外循环 (CPB)方法。方法　对 15 5例体重在 5kg以下的危重先天性心脏病婴儿进行了CPB下的外科纠治术。年龄为 ( 3 .5± 2 .4)m ,体重为 ( 4.4± 0 .7)kg。其中 44例采用深低温停循环方法 ;7例采用深低温低流量方法 ;2 3例采用深低温停循环结合低流量方法 ;18例为中度低温转流方法 ;3 7例为浅低温转流 ;另外 18例是采用常温CPB方法。 5 2例采用改良超滤 (MUF)方法 ,4例进行常规超滤 (CUF)方法 ,90例运用常规超滤结合改良超滤方法。结果　CPB时间为 ( 75 .7± 41.5 )min ,主动脉阻断时间是 ( 48.9± 2 4.1)min,停循环时间为 ( 3 3 .9± 15 .1)min,低流量时间为 ( 62± 2 8.9)min。 90例采用CUF和MUF方法相结合 ,在转流期间CUF方法滤出液体 ( 2 5 1.2± 13 8.3 )ml。死亡 13例 ,死亡率 8.3 %。结论　采取减少预充量、合适的灌注流量和转流方法、超滤、pHSTAT和αSTAT方法的血气管理可取得良好效果     

MUF和BUF在小儿心肺转流术中的联合应用

目的:比较并评价平衡超滤和改良超滤在小儿心肺转流术(CPB)中的效果.方法:60例先天性心脏病患儿随机分成平衡超滤(BUF)组、改良超滤(MUF)组和BUF联合MUF(B M)组3组,分别在整个CPB期间、停CPB后和全过程进行超滤.结果:各组临床资料无差异,BUF组在CPB中滤出液体(415±136)ml,MUF组滤出(294±81)ml,B M组滤出(726±153)ml;BUF组在CPB过程中炎症因子浓度无明显变化,而MUF组则有上升趋势,B M组在CPB结束时炎症因子浓度明显低于MUF组(P＜0.05);MUF组进行超滤时,血细胞比容明显提高,炎症因子浓度有所上升.结论:平衡超滤法能在CPB中维持较低的体内炎症介质浓度;改良超滤法可以在术后迅速浓缩血液,但对降低炎症介质的浓度影响较小;BUF联合MUF在CPB中既可以维持较低的体内炎症介质浓度又能在术后迅速浓缩血液.     

婴儿心脏直视手术中两种超滤法应用的对比研究

目的　比较常规超滤 (CUF)和CUF加改良超滤 (MUF)在婴儿心脏直视手术中应用及效果。方法　选取 4 0例单纯室间隔缺损 (VSD)行修补术的婴儿随机均分为两组 ,C组采用CUF ,M组采用CUF +MUF ,两组用相同的方法进行体外循环 (CPB)。观察 :⑴CPB预充总量、手术总用血量、CPB总入量、红细胞压积 (Hct)、超滤量、尿量、残血量等 ;⑵术前、术毕、术后 4h、术后 2 4h血浆白细胞介素 (IL) - 6 ,IL - 8、肿瘤坏死因子 (TNF -α)水平 ;⑶术后血管活性药物的应用、机械通气时间、ICU停留时间。结果　⑴两组预充总量、手术总用血量、CPB总入量、尿量无统计学差异 ,超滤量M组 (4 36± 82 )ml显著多于C组 (347± 5 7)ml,P <0 .0 5 ;残血量M组 (135± 2 3)ml少于C组(16 8± 32ml) ,P <0 .0 1;术毕HctM组 (0 .36± 0 .0 4 )高于C组 (0 .32± 0 .0 5 ) ,P <0 .0 5。⑵术毕TNF -αM组 (97.6± 18.4 )pg/ml显著高于C组 (83.1± 16 .5 )pg/ml,P <0 .0 5 ;余各时点、各指标 2组间均无统计学差别。⑶术后血管活性药物的使用、机械通气时间、ICU停留时间 2组间无显著差异 ,胸腔引流量M组 (96 .4± 2 8.7)ml少于C组(117.3± 32 .6 )ml,P <0 .0 5 ;术后输血量 (4 6 .4± 17.1)ml少于C组 (6 1.5± 2 5 .0 )ml,P <0 .0 5。结论　与CUF     

平衡超滤加改良超滤对20例婴幼儿体外循环术后肺功能的影响

目的 观察平衡超滤(BUF)加改良超滤(MUF)对婴幼儿体外循环术(CPB)后肺功能的影响.方法 40例先天性心脏病患儿,随机分成平衡超滤加改良超滤(BUF+MUF)组及常规超滤(CUF)组,各20例.测定两组超滤前、后的HCT,根据血气分析结果及FiO2计算术后2 h的氧合指数(OI),记录两组术后输血量及呼吸机辅助呼吸时间(MAT),分别在手术开始前、CPB结束、术后3、6、24 h采集桡动脉血测定肿瘤坏死因子(TNF-α)、白细胞介素-8(IL-8).结果 (BUF+MUF)组超滤后的HCT明显高于CUF组,(BUF+MUF)组术后2 h的OI较CUF组高,呼吸机辅助呼吸时间亦明显短于CUF组.停机时及术后各时间点的TNF-α和IL-8水平,( BUF+MUF)组低于CUF组.结论 平衡超滤加改良超滤能提高术后HCT及OI,缩短MAT,并能有效降低TNF-α、IL-8的水平,减轻全身炎症反应,使患儿能在术后尽早脱机,减少CPB术后并发症,促进术后肺功能的恢复.     

不同超滤方法用于婴幼儿先心病体外循环手术的围术期比较

目的比较不同超滤方法对于低体重先心病体外循环手术病人围术期的影响。方法回顾性分析我院采用改良超滤前后13例低体重（〈15 kg）先心病体外循环手术病人的临床状况,其中常规超滤（CUF）组6例,常规超滤＋改良超滤（CUF＋MUF）组7例,对比指标包括转流时间;主动脉阻断时间;转流前后的血球压积及血红蛋白,术后引流量,术后呼吸机通气时间,ICU滞留时间,围术期红细胞悬液用量,呋塞米的使用情况。结果体外循环前后Hct、Hb和总细胞悬液用量无统计学差异（P〉0.05）;手术后呋塞米用量和胸腔引流量CUF＋MUF组明显小于CUF组（P〈0.05）。结论改良超滤技术可以改善婴幼儿体外循环心脏手术后病人的器官功能及预后。     

改良超滤对成人重症心脏瓣膜置换术的影响

目的 探讨改良超滤技术(MUF)在成人重症心脏瓣膜置换术中的影响.方法 50例重症心脏瓣膜病患者随机分为实验组(MUF组,n=25)和对照组(CUF组, n=25),在术中分别采用改良超滤和常规超滤 (CUF),对两组术后早期临床资料进行对比研究.结果 两组间的红细胞比容(Hct)在术前、超滤前差异无统计学意义(P>0.05) ,在超滤后MUF组高于CUF组(P<0.01),MUF组术后出血及库血使用均低于CUF 组(P<0.05) ,术后血流动力学较平稳,呼吸机支持时间较短,术后24 h 尿量明显减少.但术后ICU滞留时间、病人下床活动时间以及术后出院时间差异无统计学意义(P>0.05).结论 改良超滤可在手术后短时间内浓缩血液,提高Hct, 改善肺功能,减少出血和库血使用,但不能改善患者远期预后.     

负平衡超滤联合改良超滤对瓣膜置换患者术后肺功能和早期认知功能的影响

目的 观察负平衡超滤联合改良超滤对瓣膜置换患者术后肺功能和早期认知功能的影响.方法 60例择期行二尖瓣置换术的患者分为常规超滤组(CUF组)和负平衡超滤+改良超滤组(S+M组),每组各30例.CUF组于复温后开始超滤,转流结束前停止超滤;S+M组转流开始10 min后行负平衡超滤,停机后行改良超滤.于转流前(T1)、转流结束即刻(T2)、术后2(T3)、12(T4)和24 h(Ts)取动脉血标本,做血气分析并测定肿瘤坏死因子-α(TNF-α)及白细胞介素-6(IL-6)的浓度;记录T1～ T5各时间气道峰压(Peak)、呼吸停顿压(Ppause)、潮气量(Tv)和吸入氧浓度(FiO2),计算肺静态顺应性(CLst)、肺泡-动脉氧分压梯度(AaDO2)及氧合指数(OI).记录两组患者术中超滤量、清醒时间、呼吸机辅助呼吸时间.于麻醉前24h、术后24、48和72 h时用简易精神状态量表(MMSE)测试患者的认知功能,记录术后72 h内术后认知功能障碍(POCD)的发生率.于转流前、超滤前及超滤后取动脉血,测定各时点患者血浆胶体渗透压(COP)及红细胞压积(Hct).结果 与T1相比,在T2～Ts时两组患者CLst和OI均降低,AaDO2、血浆内TNF-α及IL-6的浓度均升高;与CUF比较,在T2～T5时S+M组患者CLst和OI升高,AaDO2、血浆内TNF-α及IL-6的浓度均降低,差异有统计学意义(P＜0.05);与CUF组比较,S+M组患者超滤量明显增多,术后患者的清醒时间、呼吸机辅助时间均减少,差异有统计学意义(P＜0.05);与术前24 h比较,两组患者术后24、48和72 h时的MMSE评分值均降低;与CUF组比较,S+M组患者术后48和72 h时MMSE评分值增加,术后72 h内POCD的发生率明显降低,差异有统计学意义(P＜0.05).超滤后S+M组患者血浆COP和Hct与CUF组相比均明显升高;两组患者超滤前后血浆COP、Hct比较均明显升高,差异有统计学意义(P＜0.05).结论 术中使用负平衡超滤联合改良超滤可改善瓣膜置换患者术后肺功能和早期认知功能,有利于患者术后恢复.     

复合超滤对小儿先天性心脏病术后肺功能的影响

目的探讨复合应用改良超滤和零平衡超滤对改善小儿先天性心脏病体外循环(extracorporeal circulation,ECC)术后肺功能的临床效果。方法60例行室间隔缺损修补术(VSD)的患儿随机分为四组:常规超滤组(CUF组,n=15)、改良超滤组(MUF组,n=15)、零平衡超滤组(ZUF组,n=15)和改良超滤 零平衡超滤组(M Z组,n=15)。分别检测各组围术期红细胞压积(Hct),呼吸功能氧合指数(OI),肺泡-动脉血氧分压差(P(A-a)O2),呼吸机辅助时间(MAT)及炎性介质肿瘤坏死因子α(TNF-α)和白细胞介素-6(IL-6)的浓度。结果术后各组Hct无显著性差异(P>0.05);M Z组、ZUF组和MUF组术后1 h,6 h,12 h,24 h OI高于CUF组(P<0.05),而M Z组术后1 h,6 h,12 h,24 h P(A-a)O2较ZUF组、MUF组和CUF组低(P<0.05);M Z组术后呼吸机支持时间较MUF组、ZUF组和CUF组短(P<0.05);M Z组和ZUF组停机及术后2 h,12 h,24 h TNF-α和IL-6浓度较MUF组和CUF组明显降低(P<0.05)。结论零平衡超滤加改良超滤较单一超滤方法能较好地改善小儿先天性心脏病患者术后肺功能,降低体内炎性介质浓度。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.