309对早期自然流产夫妇的染色体分析——附4例世界首报核型

目的 :分析早期自然流产与染色体异常核型的关系。方法 :检测 30 9对早期自然流产夫妇双方的外周血淋巴细胞染色体核型。结果 :早期自然流产夫妇中异常核型检出率明显高于普通人群 ,总检出率为 6 .95 %。染色体异常 2 0例 :其中平衡易位 18例 (4例为世界首报核型 ) ,增加额外小染色体 2例 ;染色体异态 2 3例 :9号染色体臂间倒位 7例 ,D、G组随体变异 2例 ,9、16号次缢痕异染色质区变异 2例 ,Y染色体异态 12例。结论 :染色体异常和异态是导致早期自然流产的重要原因之一 ,对早期自然流产夫妇进行染色体检查是必要的 ,可以寻找流产原因 ,为优生优育提供依据     

反复流产夫妇平衡易位异常核型五例分析

复发性自然流产(recurrent spontaneous abortion,RSA)是指一对夫妇发生两次或两次以上的自然流产,其病因复杂,而染色体异常是导致妊娠妇女反复流产的重要原因之一[1]。由于目前尚无有效办法治疗染色体异常导致的疾病,因此,对RSA夫妇进行染色体核型分析显得尤为重要。本研究以RSA夫妇为观察对象,经细胞遗传学检查,发现5例国内外首报的人类染色体异常核型,通过分析这5例患者及其家系的孕产史,并结合染色体核型的分析,探讨染色体异常与RSA的关系。     

染色体多态性与复发性流产的关系研究

目的:研究染色体多态性与复发性流产的关系。方法:对2011年1月至2013年6月在湖北省妇幼保健院就诊的681对(1362例)复发性流产的患者夫妇(复发性流产组),进行外周血淋巴细胞培养和染色体核型分析,同时选取373对(746例)无流产史,至少一胎足月分娩后的正常生育夫妇为对照组。结果:复发性流产组的夫妇中,染色体多态性检出率(9.03%,123/1362)高于对照组(2.41%,18/746),差异有统计学意义(P0.05)。复发性流产组中inv(9)、Yqh-、1qh+、D/G组、Yqh+、16qh+、9qh+的染色体多态性的检出率均高于对照组,差异均有统计学意义(P0.05),且复发性流产组中男性染色体多态性的检出率(11.31%,77/681)高于女性(6.75%,46/681),差异有统计学意义(P0.05)。结论:染色体多态性与复发性流产有一定关系,在复发性流产患者的病因分析中不应忽视染色体多态性的作用,男性染色体的多态性也是因素之一。     

2178对自然流产史夫妇染色体分析

目的:分析自然流产史夫妇外周血染色体异常核型的种类及其在男女性中的分布特点。方法:检测2178对自然流产史夫妇外周血淋巴细胞染色体核型,分析比较染色体变异的种类、发生率及其在男、女性中的分布差异。结果:2178对(4356例)自然流产史夫妇中发现染色体异常539例(12.37%),其中男266例,女273例。染色体结构异常87例,其中相互易位最多见为58例(66.7%,58/87),有27例为世界首报染色体结构异常核型。其次为罗伯逊易位13例,倒位6例,插入、缺失等其他异常核型10例。染色体数目异常8例,包括2例标记染色体、1例XYY及5例不同类型的X染色体非整倍体嵌合。多态性改变444例中,D/G组染色体随体区变异最为多见,共271例(61.04%,271/444)。结论:自然流产史夫妇外周血染色体异常均有发生,男女性发生率并无明显差异,染色体异常以相互易位为主。染色体多态性发生率较高,对以自然流产史就诊的夫妇,有必要同时进行染色体检查,有助于病因的分析与诊断,并为临床咨询及后续生殖干预提供依据。     

大Y染色体核型与生育异常的关系分析

目的分析大Y染色体核型与生育异常之间的关系。方法外周血淋巴细胞G显带技术检查生育异常男性患者除外染色体异常核型者474例，并与同期查体核型为46，XY的112例正常男性为对照组。结果共检出137例大Y染色体核型，发生率依次为少弱精患者41．67％、无精症患者36．84％、配偶孕早期胎停育患者27．76％、配偶不良分娩结局患者14．29％；与正常对照组发生率8．93％相比，前三种差异有显著性。结论大Y染色体核型与精子生成和配偶孕早期胎停育发生有关。     

捐精者染色体核型筛查与意义——附1681例报告

目的:探讨捐精者染色体检查的必要性。方法:1 681例精液检查符合卫生部捐精标准的捐精者,通过外周血淋巴细胞染色体制备和G显带,分析各样本染色体核型。结果:检出37例染色体核型有多态性,包括9号染色体臂间倒位14例,D、G组染色体短臂变异3例,1、9、15、16、Y染色体异染色质区长度增加6例,大Y 12例,小Y 2例。同时检测到4例染色体异常,包括罗伯逊易位1例,平衡易位2例,46,XY,[90]/46,XY,chrg(16)(q22)[10]染色体核型异常1例。结论:在精液参数符合卫生部标准的捐精者中实施染色体检查,有助于减少辅助生殖过程中流产和子代出生缺陷的风险。     

502对反复自然流产夫妇的染色体研究

对反复自然流产２次或２次以上的５０２对夫妇进行外周血培养Ｇ显带染色体核型分析。发现异常核型５２例，占５．１８％；其中平衡易位３８例，占７３．０８％；染色体数目异常５例，占９．６２％；嵌合体８例，占１５．３８％；９号染色体臂间倒位１例，占１．９２％。结果表明，平衡易位携带者是反复自然流产夫妇中最常见的染色体异常，故流产史是检出人群中平衡易位携带者的重要临床指征。     

男性不育症精子发生相关基因缺陷的筛查研究

目的:探讨男性不育患者精子发生相关基因缺陷与精子生成的关系。方法:应用多重聚合酶链反应(PCR)扩增分析方法对149例男性不育症患者及100例有正常生育能力的男子进行Y染色体上相关基因检测和常规外周血染色体核型分析。结果:不育症组有11例存在着Y染色体上不同基因片段的微缺失,缺失率为7.38％,染色体异常核型发生率为14.09％;而正常对照组均未发现相应部位的缺失,异常核型发生率为2％。11例存在Y染色体上不同基因片段微缺失者只有1例合并有异常核型,说明两者之间无相关性。结论:提示Y染色体微缺失是引起男性不育的一个重要原因,在进行单精子卵泡浆内注射(ICSI)时应进行Y染色体微缺失的分子检测,以免所生的男性后代亦有与其父亲相同原因的不育问题。     

75对早期自然流产夫妇的细胞遗传学分析

本文收集自然流产夫妇共75对临床资料,发现5例染色体异常,占受检人数的3.33%,并检出3例随体区变异.复习有关文献并结合异常病例探讨,表明:平衡易位携带者是流产夫妇中最常見的染色体异常,其检出率与流产次数和发生时间有一定的关系,具有重要的临床意义.     

FISH快速检测自然流产绒毛染色体非整倍体异常的临床价值

目的:探讨应用荧光原位杂交技术(FISH)对早期自然流产绒毛染色体非整倍体检测的临床价值。方法:对30例因自然流产行清宫术的绒毛组织行FISH分析,使用7种探针对13、16、18、21、22号和X、Y染色体进行了检测,并对这30例流产夫妇行外周血淋巴细胞染色体常规核型分析。结果:FISH分析的30例自然流产的绒毛组织中,有17例检测出了异常信号,检出率为57%,其中8例16-三体、2例22-三体、2例13-三体和5例三倍体。30例自然流产夫妇外周血淋巴细胞染色体核型未见异常。结论:FISH技术可以快速、简便地检测出流产物绒毛组织染色体非整倍体的异常,FISH技术的应用可以为自然流产夫妇遗传咨询提供重要的信息。     

自然流产夫妇的细胞遗传学研究─附10例世界首报染色体核型

用人体外周血淋巴细胞培养法对６２４对原因不明的自然流产夫妇进行了细胞遗传学研究，检出异常染色体携带者５７例，其中女３８例，男１９例。５７例染色体异常中，结构异常４５例；染色体数目异常２例；９号染色体臂间倒位９例，Ｙ染色体倒位１例。异常染色体涉及到１，３，４，５，６，７，８，９，１０，１１，１３，１４，１５，１７，１８，１９，２１，２２，Ｘ，Ｙ共２０条。４５例结构异常中１０例经湖南医科大学国家细胞遗传学培训中心鉴定为世界首报。     

自然流产夫妇的细胞遗传学研究─附10例世界首报染色体核型

用人体外周血淋巴细胞培养法对６２４对原因不明的自然流产夫妇进行了细胞遗传学研究，检出异常染色体携带者５７例，其中女３８例，男１９例。５７例染色体异常中，结构异常４５例；染色体数目异常２例；９号染色体臂间倒位９例，Ｙ染色体倒位１例。异常染色体涉及到１，３，４，５，６，７，８，９，１０，１１，１３，１４，１５，１７，１８，１９，２１，２２，Ｘ，Ｙ共２０条。４５例结构异常中１０例经湖南医科大学国家细胞遗传学培训中心鉴定为世界首报。     

Genetic aspects of miscarriage.

Fetal chromosome abnormalities account for about 50% of first-trimester pregnancy losses. Most of these abnormalities are numerical abnormalities (86%) and a low percentage is caused by structural abnormalities (6%) or other genetic mechanisms, including chromosome mosaicism (8%). The recurrence risk of numerical abnormalities is low, so karyotyping of fetal material in case of a miscarriage does not seem worthwhile in daily practice.Half of the structural abnormalities may be inherited from a parent carrying a balanced chromosome translocation or inversion. Parental carriership is found in 4-6% of the couples with recurrent miscarriage. In case of parental carriership of a balanced structural chromosome abnormality, a next pregnancy may result in a child with an unbalanced structural chromosome abnormality. This child can have multiple congenital malformations and/or a mental handicap. Prenatal diagnosis is therefore recommended.Conventional laboratory techniques, such as tissue culturing and karyotyping, or (semi-)direct chromosome technique of chorionic villi, and the recently developed laboratory techniques such as fluorescence in situ hybridization (FISH) and comparative genomic hybridization (CGH), are described successively.Until now, not enough evidence has been available about the role of other genetic mechanisms, such as single-gene abnormalities, uniparental disomy, genomic imprinting, multifactorial disorders and skewed X chromosome, in the occurrence of miscarriages.     

Chromosomal analysis in Japanese couples with repeated spontaneous abortions

Balanced chromosome rearrangements have been found at an increased frequency in couples with pregnancy wastage, especially recurrent spontaneous abortions, compared with the general population. In the present study, chromosomal analysis of peripheral blood cells, as one of the routine examinations of patients with repeated reproductive wastage, was performed on both partners of 639 Japanese couples. Among the 639 couples, 32 major chromosomal anomalies (5.0%) and 23 minor chromosomal variants (3.6%) were found. Both partners of one couple had an abnormal karyotype. The 32 major anomalies consisted of 19 reciprocal translocations, 9 Robertsonian translocations, one large inversion, two triple-X females, and one Turner mosaicism. The 23 minor variants included 15 cases of pericentric inversion of chromosome 9. The total number of pregnancies in the 54 couples with chromosomal anomalies was 181, but they resulted in only 18 normal liveborn neonates, indicating a 90.1% abortion rate. The present statistical study indicates that major chromosomal anomalies seem to be involved in repeated reproductive wastage.     

Cytogenetics of aborters and abortuses

783 aborters and 430 abortuses were studied in a prospective cytogenetic survey which attempted to link chromosome abnormalities and history of recurrent abortion. 425 female and 358 male spontaneous aborters and their 430 abortuses (310 were karotyped) showed 4 women and 2 men as balanced translocation carriers (3 Robertsonian and 3 reciprocal translocations) and a woman with an XXX karotype. 5 of the abortuses were successfully karotyped; 4 had inherited unbalanced translocation products, and the other had a balanced 13q14q translocation plus trisomy 18. Apparently, translocation chromosomes carried by aborters were transmitted to their abortuses. Structural chromosome abnormalities were found with higher frequency (.8%) among aborters than among the general adult population (.3%). Translocation carriers were more frequent among the aborters with histories of recurrent abortions (2.7%) as well as among aborters with a history of perinatal deaths (3.6%) than among those persons with no such histories (.6%). Data on 18 couples whose 2 or 3 successive spontaneous abortuses were karotyped are presented.     

Implications of Sperm Chromosome Abnormalities in Recurrent Miscarriage

Purpose: Our purpose was to assess the existence of sperm chromosome abnormalities in recurrent pregnancy loss in an assisted reproduction program. Methods: In this prospective study, 12 sperm samples from couples undergoing in vitro fertilization with two or more first-trimester spontaneous abortions were analyzed. Diploidy and disomy in decondensed sperm nuclei were assessed for chromosomes 13, 18, 21, X, and Y using two- and three-color fluorescence in situ hybridization. Results: Sex chromosome disomy in sperm samples from recurrent abortion couples was significantly increased compared to that from internal controls (0.84% vs 0.37%). In a subpopulation of seven couples who underwent oocyte donation, mean frequencies for sex chromosome disomy (1%) were even higher and diploidy (0.43%) was also significantly increased. Conclusions: These results suggest an implication of sperm chromosome abnormalities in some cases of recurrent pregnancy loss.     

169例染色体异常核型分析——附4例世界首报核型

目的:探讨染色体异常核型的临床意义。方法:对疑有染色体异常的2800例患者进行外周血淋巴细胞培养,常规G显带,必要时C显带。结果:2800例中发现169例异常核型,异常率6％。涉及到的染色体有1,4,5,6,9,10,12,13,14,15,16,17,20,21,22,X,Y。包括染色体数目异常、缺失、倒位及嵌合。结论:染色体异常是重复流产、智力低下、闭经及胎儿畸形的主要原因之一,具有重要的临床意义。     

Chromosome study of couples with repeated spontaneous abortions

The incidence of chromosomal abnormalities was evaluated in couples with a history of repeated abortions. The study included 14 couples with a history of 2 or more spontaneous abortions. Chromosome analysis was carried out on both marital partners from peripheral lymphocyte cultures. In every case, 30-62 metaphases were counted, and at last 20 karyotyped. Among the 14 couples, chromosome anomaly was found in 1 of the partners in 1 case. The patient, a 29-year-old female, was admitted to the hospital in the 36th week of her 10th pregnancy. In addition to an induced abortion and a premature delivery, her history included 7 spontaneous abortions at the 1st or 2nd month. Chromosome analysis of her peripheral blood revealed neither numerical nor structural aberations. In the 38th week, the patient gave birth ato a 3990 gm healthy boy whose karyotype of the cord blood also proved to be normal. The karyotype of the patient's husband revealed 45 chromosomes in 32 observed cells, and a chromosome was missing from each of the D and G groups. It was not possible to include in any of the groups a medium-sized, subterminal chromosome, diagnosed as D/G translocation. The husband proved to be a balanced D/G translocation carrier. When the pedigree was prepared, it was found that the younger sister of the husband had given birth to a child 1 month before term. Both the sister and her child were studied. The sister proved to be a balanced D/G translocation carrier. The child had translocational Down's syndrome: the D/G translocation occured in an unbalanced form. A table lists the results of chromosome investigations of cases of repeated abortions. Of 1066 married partners, chromosome aberations or variations responsible for multiple abortions were found in 70 (6.5%). Of these, 26 proved to be translocations. This incidence, 2-4%, is higher than the .4% in the general population. The results add credence to the argument that chromosome aberation may play a role in the causal background of recurring abortions. It is possible that with special staining procedures some aberations can be demonstrated in cases hitherto considered normal. In cases of repeated abortion, cytogenetic examination of both partners is routinely justified. In cases of chromosome aberations valuable data can be gained to serve as a basis for genetic counseling. When examining women with recurrent abortions, it should be possible to select patients to whom the possibility of intrauterine cytogenetic diagnosis can be offered.