181例Turner综合征染色体核型分析与性激素检测

目的分析Turner综合征患儿染色体不同核型的遗传学特征及其与性激素水平的关系。方法将181例Turner综合征患儿根据染色体核型分成3组进行统计分析,并对其中75例测定性激素患儿与30例健康女孩血清性激素水平进行比较,并作对照统计分析。结果 181例Turner综合征中检出45,X核型84例（46.4%）,嵌合型25例（13.8%）,X染色体结构畸变72例（39.8%）;45,X核型和结构畸变核型组患儿血清中促卵泡生成素（FSH）和促黄体生成素（LH）浓度明显高于对照组（P〈0.05）,嵌合体核型与对照组差异则无统计学意义;45,X核型组中有4例患儿血清FSH、LH处于正常水平。结论对于青春前期的生长落后女性患儿建议常规进行染色体核型分析,以排除染色体异常或明确诊断。多数TS患儿伴有血清性激素水平的异常。不同核型对性激素水平影响明显,性激素水平检测对了解Turner综合征患儿生殖内分泌状态非常必要,可以为激素替代治疗提供依据。     

Turner综合征的临床与实验检查研究

目的探讨Turner综合征(TS)的染色体核型与性发育异常、卵巢发育不全的关系.方法48例TS患者行染色体检查,32例行子宫、卵巢B超影像学检查,20例行性激素和促性腺激素测定.结果染色体核型分四组:第1组45,X,33例;第2组嵌合型,5例;第3组X染色体结构畸变,8例;第四组带有Y染色体,2例.13例有不同程度的性发育,19例无性发育.20例的雌二醇(E2)、睾酮(T)及泌乳素(PRL)浓度明显低于正常人,促卵泡生成素(FSH)和促黄体生成素(LH)明显高于正常女性.结论Turner综合征患者染色体核型与临床表现有关.X染色体异常致患者卵巢发育不全,并使体内性激素水平异常.     

Turner综合征的实验临床综合研究

目的研究Turner综合征的终身高、生长激素水平、学历和性发育的变化.方法239例Turner综合征进行染色体检查,68例行生长激素激发试验,45例随访学历和性发育的情况.结果染色体核型分4组,第1组45,X,95例;第2组嵌合型64例;第3组X染色体结构畸变74例;第4组伴有Y染色体6例.终身高139.2±8.3cm.生长激素完全缺乏18例,部分缺乏34例,正常16例.随访45例中,学历大部分在初中、技校和中专19例有不同程度的性发育,26例无性发育.结论Turner综合征患者终身高明显低于正常人群,生长激素分泌低下,学习能力降低,性发育不全.     

Turner 综合征的临床实验综合研究

目的研究Turner综合征的终身高、生长激素水平、学历和性发育的变化。方法239例Turner综合征进行染色体检查,68例行生长激素激发试验,45例随访学历和性发育的情况。结果染色体核型分4组,第1组45,X,95例;第2组嵌合型64例;第3组X染色体结构畸变74例;第4组伴有Y染色体6例。终身高139.2±8.3?。生长激素完全缺乏18例,部分缺乏34例,正常16例。随访45例中,学历大部分在初中、技校和中专19例有不同程度的性发育,26例无性发育。结论Turner征患者终身高明显低于正常人群,生长激素分泌低下,学习能力降低,性发育不全。     

54例Turner综合征患儿的细胞遗传学和临床效应分析

目的了解Turner综合征的常见细胞遗传学核型及临床效应。方法常规外周血淋巴细胞培养制备染色体标本,采用G显带技术进行核型分析1732例女性患儿,对其遗传学检测结果,临床效应及就诊年龄时段进行回顾性分析。结果检出染色体核型确诊为Turner综合征的为54例,外生殖器男性7例,外生殖器女性47例Turner综合征患儿临床表现复杂,染色体核型多样,主要核型以X单体,嵌合型X染色体结构异常多见。这些患儿1岁前主因发育迟缓和外生殖器异常就诊,青春期因身材矮小就诊多见,部分患儿有不同程度的精神运动发育迟缓。智力低下或外生殖器发育异常。结论 X染色体缺失,嵌合体或结构异常是导致Turner综合征的主要原因,身材矮小,第二性征发育不良为就诊主诉,染色体核型多样,不同核型个体导致不同临床效应,了解该病的临床表现极其形成原因,对及早的确诊该病,对该类患儿的成长指导具有重要意义。     

463例Turner综合征的临床资料与染色体核型分析

目的探讨和分析Turner综合征（Turnersyndrome，TS）的临床表现与不同染色体核型的关系。方法对463例可疑的Turner综合征患儿进行染色体核型分析，记录部分病人的主要临床表现，并根据需要对部分病人进行性激素、生长激素、骨龄和盆腔超声的检查。结果染色体核型为45，x的179例（38．66％）；X染色体无结构异常的嵌合型56例（12．10％）；X染色体结构异常的68例（14．68％）；X染色体数目和结构均异常160例（34．56％）。本文资料中表现为身材矮小的占81．07％；骨龄落后占59．44％；卵巢未被探及占17．10％；卵巢发育不良占72．36％；子宫幼稚型占48．54％；始基子宫占38．83％。促卵泡刺激素（FSH）和促黄体生成素（LH）升高、雌二醇（E，）降低的占95．58％。生长激素筛查试验（运动后）〈10¨g／L的占68．50％。结论Turner综合征的染色体核型呈多样性，不同的核型临床表现存在一定的差异。对Turner患儿进行性激素、生长激素、骨龄、卵巢和子宫状况等检查可全面了解病情和指导临床治疗。     

Turner综合征的临床与实验检查研究

目的探讨Turner综合征(TS)的染色体核型异常与躯体发育异常、卵巢发育不全、性激素激素异常以及矮小和骨龄落后的关系.方法对11例TS患儿进行染色体、性激素和促性腺激素、骨龄和子宫、卵巢B超影像学检查及身高评价.结果染色体核型各异,患儿矮小和各种躯体畸形.B超检查患儿或无子宫和/或卵巢声像,或其发育落后(P＜0.01或P＜0.05).血E2降低,血促性腺激素升高(P＜0.01).骨龄落后2.4±1.5岁,身高的标准差积分为-3.9±1.2.结论TS的染色体核型与患儿临床表现有关.矮小和骨龄(BA)落后可能与SHOX基因缺失、雌激素缺乏、生长激素缺乏及甲状腺功能低下等有关.X染色体异常致患儿卵巢发育不全,并使体内性激素水平异常.     

Turner综合征的核型、临床表现与性激素的分析

目的探讨Turner综合征患者染色体异常核型与性发育异常和激素水平异常的关系。方法对我院2003年以来72例Turner综合征患者进行染色体核型分析、临床表现分析及性激素水平检测。结果72例原发性闭经患者中检出核型异常者58例；发现有9种异常临床表现，身材矮小55例（76．4％），发际低33例（45．8％），有颈蹼者28例（38．9），面部有黑痣者37例（51．4％），乳房未发育66例（91．6），肘外翻46例（63．90％），无腋毛、阴毛66例（91．6％），无月经67例（93％），外阴幼稚型66例（93％）。性激素检查结果表明Turner综合征患者血中雌二醇（E2）、睾酮（T）及泌乳素（PRL）浓度明显低于正常人，而促卵泡生成素（FSH）和促黄体生成素（LH）浓度明显高于正常女性。结论Turner综合征患者的染色体核型与患者临床表现有关。X染色体异常致患者卵巢发育不全，并使体内性激素水平异常。     

大连地区78例Turner综合征的临床特征与染色体核型分析

目的探讨Turner综合征（TS）不同核型的遗传学特征、临床特点及其所占比例。方法成人外周血染色体核型分析,高危孕妇羊水染色体核型分析。结果成人外周血检测发现TS 75例,羊水检测发现TS 3例。78例患者中,45,XO 32例（41%）,45,XO/46,XX嵌合型10例（12.8%）,45,XO/46,XX/47,XXX嵌合型2例（2.6%）,45,XO/47,XXX嵌合型4例（5.1%）,46,X,i（X）4例（5.1%）,45,XO/46,X,i（X）嵌合型9例（11.5%）,46,X,del（Xp-）7例（9.0%）,46,X,del（Xq-）7例（9.0%）,45,XO/46,X,del（Xp11）嵌合型2例（2.6%）,45,XO/46,X,del（Xq21）嵌合型1例（1.3%）。结论 TS核型主要包括X单体型,X单体嵌合型和结构畸变型及其嵌合型三种,45,XO的X单体型为本综合症的主要类型;不同核型患者临床表现可存在差异;对有相关临床表现的女孩争取做到早诊断,早治疗;对部分具有一定生育能力的TS患者做好产前诊断,做到优生优育。     

特纳综合征患者的染色体核型及临床表现特点

目的:分析特纳综合征(Turner syndrome,TS)患者的染色体核型及临床特点,以提高对此病的认识和诊疗水平,为早期发现特殊核型提供临床依据.方法:对确诊患者的临床表现、性激素水平、骨龄及染色体核型等进行分析和总结.结果:24例确诊为TS患者,首发临床表现均为身材矮小,有50％骨龄比实际年龄延后;50％具有TS典型体征,83.33％有促性腺激素水平明显偏高,50％未见卵巢组织;染色体核型分析提示33.33％为45,XO,50％为45X嵌合体,其余为其他类型;16.67％的患者有垂体瘤,8.33％有心血管结构异常,部分患者心电图有异常,8.33％有促甲状腺激素水平增高;PCR检测SRY基因均阴性,未发现Y染色质.结论:TS患者因细胞核型的不同,临床表现有所差异,且各种核型与临床表现有时并不完全相对应;对于矮小症女童,应常规行染色体核型分析;对于出现不能由传统核型分析鉴定的特殊染色体或者核型为45,XO的患者尽早行Y染色体检测,有利于发现异常的Y染色体,为是否需要预防性切除性腺提供依据.     

Familial Turner syndrome with an X;Y translocation mosaicism: Implications for genetic counseling

Spontaneous fertility is rare among patients with Turner syndrome and is most likely in women with mosaicism for a normal 46,XX cell line. We report an unusual case of familial Turner syndrome with mosaicism for a novel X;Y translocation involving Xp and Yp. The chromosomal analysis was carried out through cytogenetics and molecular karyotyping using a SNP array platform. The mother, a Turner syndrome woman, diagnosed in midchildhood because of short stature, was found to have a 45,X/46,X,der(X)t(X;Y)(p11.4;p11.2) karyotype, with a predominant 45,X cell line. Her parents decided against prophylactic gonadectomy, generally recommended at an early age when Y chromosome has been identified, because at age 13, she had spontaneous puberty and menarche. She reached a final height of 154 cm after treatment with growth hormone. At age 24, she became spontaneously pregnant. She had a mild aortic coarctation and close follow-up cardiac evaluation, including cardiac magnetic resonance imaging, had been performed during her pregnancy, which progressed uneventfully, except for intra-uterine growth retardation. Prenatal diagnosis revealed a female karyotype, with transmission of the maternal translocation with an unexpected different mosaic:47,X,der(X)t(X;Y)x2/46,X,der(X)t(X;Y) karyotype. This complex and unusual karyotype, including a mosaic partial trisomy X and a non-mosaic Xpter-Xp11.4 monosomy, results in transmission of Turner syndrome from mother to daughter. At birth, the girl had normal physical examination except for growth retardation. This family illustrates the complexity and difficulties, in term of patient counseling and management in Turner syndrome, in determining ovarian status, fertility planning, risks associated with pregnancies, particularly when mosaicism for Y material chromosome is identified.     

兰州地区61例Turner综合征核型及临床特征分析

目的探讨Turner综合征患者的染色体核型异常与内分泌激素异常、发育异常和骨龄落后的关系。方法对61例Turner综合征患者进行染色体核型分析、内分泌激素六项检测、B超检查及身高评价。选择同期健康体检人群作为对照组。结果 Turner综合征染色体核型各异,患者表现为身材矮小和躯体畸形,B超检查患者无子宫和/或卵巢,与正常对照组相比发育明显落后（P〈0.01）;患者血清FSH、LH明显高于对照组,E2、P低于对照组,PRL、T无明显差异;身高及骨龄明显落后。结论 Turner综合征的染色体核型与患者临床表现相关,骨龄落后和身材矮小可能与SHOX基因缺乏、雌激素缺乏有关。     

Discordant phenotypes and 45,X/46,X,idic(Y).

Mosaicism introduces wide variability into the clinical expression of numerical and unbalanced structural chromosomal abnormalities. The phenotypic range of variability of 45,X/46,XY mosaicism extends from Turner syndrome to mixed gonadal dysgenesis to normal males. The specific phenotype is primarily dependent on the chromosomal constitution of the developing gonad. Similar phenotypic variability is observed with mosaicism for 45,X and a second cell line with an abnormal sex chromosome. This report describes a patient with Turner syndrome and a patient with mixed gonadal dysgenesis who have identical karyotypes, namely 45,X/46,X,idic(Y)(p11.2). While mosaicism alone might have accounted for the phenotypic differences, by PCR analysis the Turner syndrome patient was SRY and ZFY negative and the mixed gonadal dysgenesis patient was SRY and ZFY positive.     

北海地区73例Turner综合征患者细胞遗传学分析

目的研究Turner综合征与细胞染色体异常之间的关系。方法采用外周血淋巴细胞培养，G显带技术染色体核型分析技术对73例Turner综合征患者进行核型分析。结果73例TurnerN合征患者的临床表型复杂，核型各异。其中以X单体型、嵌合型为主，还有X缺失型等。结论Turner综合征是，临床上女性患者不孕不育、身材矮小等的重要病因，无有效的方法，及旱确诊对该病的防治具有积极意义。     

Phenotypic and genotypic variability in monozygotic triplets with Turner syndrome

Turner syndrome (TS) is a common disorder (1/2500 and 1/5000 female births) which is diagnosed at birth in approximately 20% of patients and during childhood (usually due to growth retardation) or later, (due to lack of pubertal development) for the remaining patients. Here we present a cytogenetic and molecular analysis of three monozygotic sisters. The diagnosis of TS was done for one of them (patient 1) who presented with a typical Turner phenotype. A first karyotype was established as normal and a second karyotype (carried out on 200 cells) revealed a 45,X/46,XX mosaicism with 6% of cells with a 45,X karyotype. Lymphocyte karyotype analysis showed the same mosaicism pattern for the two other sisters, one of them exhibiting only a mild (patient 2) and the other no clinical features of Turner syndrome (patient 3). Karyotype analysis was this time conducted on fibroblasts and showed that the 45,X/46,XX mosaicism pattern correlated with the clinical phenotype with 99, 43 and 3% of 45,X cells in patients 1, 2, and 3, respectively.
These data suggest that different tissues other than lymphocytes should be subjected to a karyotype analysis when the observed genotype does not correlate with the clinical phenotype.     

Turner syndrome: evaluation of prenatal diagnosis in 19 European registries

This study evaluated the prenatal diagnosis of Turner syndrome by ultrasound examination in an unselected population from all over Europe. Data from 19 congenital malformation registries from 11 European countries were analyzed. Turner syndrome was diagnosed in 125 cases (7.2%) in a total of 1,738 chromosome abnormalities. Sixty-seven percent of cases were detected prenatally by ultrasound examination due to the presence of congenital defects. The most frequent anomalies were cystic hygroma (59.5%) and hydrops fetalis (19%). The most frequent karyotype was 45,X (81.6%) followed by different types of mosaicism (16.8%). Significant differences in congenital defects (P = 0.0003) were observed between 45,X karyotypes and 45,X mosaicism cases. Prenatal counseling for 45,X mosaicism should take into account the expectation of a milder phenotype. In 78.6% of cases diagnosed by ultrasound examination due to congenital anomalies, the pregnancy was terminated. Prenatal detection of Turner syndrome by ultrasound examination was high in this unselected population.     

96例Turner综合征患者临床特征及染色体分析

目的Turner综合征患者身材矮小伴不同程度的性腺发育不全,探讨Turner综合征不同核型的遗传学特征、临床特点及其所占比例。方法无菌取患者外周血,淋巴细胞常规培养制作染色体标本,胰酶法G显带,显微镜下进行染色体核型分析。结果96例Turner综合征患者的染色体核型为：45,x,39例（40．6％）;45,Ⅺ／46,XX21例（21．9％）;46,XY11例（11．5％）;46,Xi（Xq）10例（10．4％）;46,X,del（x）（q22。qter）6例（6．3％）;45,X／46,Xi（X）（q10;q10）3例（3．1％）;47,XXX3例（3．1％）;45,X／46,X,del（X）（022—pter）2例（2．1％）;45,Ⅺ／46,X,r（X）（p22q28）1例（1．04％）。结论Turner综合征患者的染色体有数目异常和结构畸变等多种核型,均可不同程度导致女性闭经、性腺发育异常及智力低下等症状,应提倡优生优育,做好产前诊断。     

Isodicentric Y chromosome in an Ullrich‐Turner patient without virilization

We report on a 17‐year‐old young woman with Ullrich‐Turner syndrome (UTS), who was found to have a karyotype 45,X/46,X,idic(Y)(q11). She had age‐appropriate genitalia without virilization in spite of the presence of the Y‐derived marker chromosome and SRY locus in 70% of her lymphocytes. Having reviewed the literature, we conclude that a possible explanation for the lack of virilization in these mosaic patients is most likely an uneven distribution of tissue mosaicism (gonadal mosaicism). Am. J. Med. Genet. 91:99–101, 2000. © 2000 Wiley‐Liss, Inc.     

青春期Turner综合征22例临床特点与治疗现状分析

目的探讨青春期Turner综合征的临床特点与治疗现状。方法分析2009年1月至2011年6月在我院诊断的年龄11至18岁青春期Turner综合征的临床表现,实验室及影像学检查及治疗现状。结果 1.22例患儿均以性腺不发育或无月经初潮为主诉而就诊,而就诊时已有8至14年生长迟缓或停滞病史均未引起家长重视。2.染色体X单体11例(50%),嵌合体6例(27.3%),等臂体5例(23.7%)。3.性激素水平只有1例E2、FSH、LH均降低外,其余21例为E2降低,而FSH LH明显升高。4.骨龄全部落后。5.B超盆腔1例轻度发育呈青春早期外,21例子宫卵巢均发育不良。6.14例骨龄小于12岁的患儿2例接受短期生长激素治疗,8例骨龄大于12岁患儿,1例接受短期性激素替代治疗。结论 Turn-er综合征青春期儿童以性腺不发育或无月经初潮为主要症状,无青春期生长加速;染色体检查有诊断意义,核型分型与其他年龄组一致;性激素水平、骨龄、B超盆腔有重要诊断价值,治疗现状不容乐观。