武汉地区497例少、弱、畸精子或无精子症患者细胞遗传学分析

目的分析男性不育患者染色体核型。方法对497例少弱畸精子或无精子症患者进行外周血G显带染色体核型分析,并跟踪核型正常者其助孕结局。结果检出染色体核型异常62例,异常率为12.47%（62/497）。其中少、弱、畸、精子症患者306例,核型异常率12.4%（38/306）,无精子症患者191例,染色体核型异常率为12.7%（24/191）。结论染色体核型异常是导致男性不育的重要原因。     

清远地区162例少、弱、畸、无精子症患者细胞遗传学分析

目的研究清远地区男性不育患者的染色体异常。方法运用染色体G显带和C显带方法,对162例原发少、弱、畸、无精子症等不育患者的核型进行分析。结果发现69例患者有染色体异常,频率为42.59%。结论染色体异常是导致男性不育的重要原因。     

92例男性少、弱精子症和无精子症患者的细胞遗传学分析

目的分析少、弱精子症和无精子症患者染色体畸变的特点。方法对92例少、弱精子症和无精子症患者进行外周血淋巴细胞培养,制片,常规G显带,核型分析。结果 92例患者中染色体异常核型16例,占全部被检者的17.4%;其中常染色体异常6例,占染色体异常核型37.5%;性染色体异常10例,占染色体异常核型62.5%。     

146例少、弱精子症、无精子症患者细胞遗传学分析

目的分析少、弱精子症、无精子症患者染色体异常的特点。方法对146例少、弱精子症、无精子症患者进行外周血淋巴细胞培养、制片、常规G显带、核型分析。结果146例患者中染色体异常核型28例,占全部被检者19.2%;其中常染色体异常7例,占染色体异常核型25%;性染色体异常21例,占染色体异常核型75%。     

175例男性少、弱精子及无精子症患者的细胞遗传学分析

目的 了解男性少、弱精子及无精子症患者与染色体核型的关系,以明确男性不育的病因.方法 对175例经精液常规和形态检测,临床诊断为少、弱精子及无精子症的男性患者,抽取外周静脉血进行淋巴细胞培养、制片、核型分析.结果 175例少、弱精子及无精子症患者的细胞遗传学分析结果中检出染色体异常者67例,总检出率为38.29％.其中染色体结构异常者11例,占6.29％,染色体数目异常者35例,占20.00％,染色体多态性变异者21例,占12.00％.结论 染色体异常可能是导致男性少、弱精子及无精子症的重要因素之一,对少、弱精子及无精子症男性患者进行染色体核型分析,对指导临床治疗具有重要价值.     

少、弱精子及无精子症患者染色体核型分析

目的探讨染色体异常对少弱精子及无精子症的影响.方法对199例男性少、弱精子及无精子症患者进行外周血淋巴细胞培养,G显带染色体核型分析.结果染色体核型异常20例, 占10.1%; 染色体变异19例,占5.3%.结论染色体异常是导致少、弱精子及无精子症的重要因素之一.     

少精子症、弱精子症111例的染色体分析

目的对我院2000年1月至2001年5月就诊的男性无精子、少、弱精子症患者进行病因分析.方法按WHO精液检查标准进行精液常规检查.结果查出精液质量异常者111例,其中无精症72例,染色体异常29例,占40.3%;少、弱精子症39例,染色体异常9例,占23.1%.结论染色体异常是导致男性精液质量异常、不育的重要病因之一.     

163例少、弱精子症和畸形精子症及无精子症患者的染色体分析

目的探讨染色体核型异常与男性精子质量异常的关系。方法对于临床诊断为少弱精子症,畸形精子症以及无精症患者进行外周血染色体核型分析。结果在163例患者中染色体核型中染色体异常11例,异常率6.7%,其中常染色体异常5例,性染色体异常6例;染色体多态21例,检出率12.8%。结论染色体异常是引起男性精子异常的重要原因,对于临床诊断为少弱精子症、畸形精子症及无精子症的患者进行染色体检查有非常重要的意义。     

抗生殖免疫抗体与不明原因反复自然流产的关系

目的：为探讨抗生殖免疫抗体与不明原因反复自然流产的关系。方法：采用ELISA法检测52例不明原因反复自然流产(流产组)血清抗精子抗体(AsAb)、抗子宫内膜抗体(EmAb)、抗卵巢抗体(AovAb)、抗心磷脂抗体(AcAb)和抗绒毛膜促性腺激素抗体(AhcGAb)的含量。结果：流产组AsAb阳性26．92％,EmAb阳性42．30％,AovAb阳性30．76％,AcA阳性46．15％和AhcGAb阳性48．07％;流产组的各项抗生殖免疫抗体检出率均明显高于对照组。结论：以上5种抗生殖免疫抗体可干扰卵的发育成熟、排卵、受精、胚泡着床和胚胎发育等过程。抗生殖免疫抗体与不明原因反复自然流产关系十分密切。     

不明原因复发性流产与精子DNA完整性的关系

目的探讨不明原因复发性流产与男方精子DNA完整性的关系。方法精子DNA完整性检测采用精子染色质扩散试验（sperm chromatin dispersion,SCD）,以DNA断裂指数（DNA fragmentation index,DFI）表示。分别对不明原因复发性流产男方与无流产史男方精子进行精液常规分析和DFI分析。结果流产组精子密度、活动率、前向运动率和DFI与生育组比较差异有统计学意义（P〈0.05）。结论不明原因复发性流产可能与精子DNA损伤存在一定关系。     

HLA-E polymorphism in patients with recurrent spontaneous abortion

Abstract: The aim of this study was to compare the frequencies of five HLA-E alleles in 82 women with recurrent spontaneous abortions with that of 150 random Danish controls. PCR sequence-specific oligonucleotide typing was carried out to detect polymorphism in exons 2 and 3 of the HLA-E gene. In informative samples sequencing of these two exons was also undertaken to confirm the presence of the HLA-E*01031 allele. HLA-E*0101, HLA- E*01032 and HLA-E*01031 were detected with frequencies of 56.7%, 33.6% and 9.6% in controls and 58,5%, 32.9% and 8.5% in patients with recurrent abortion, respectively. No HLA-E*0102 and E*0104 alleles could be detected. Since the HLA-E allele distribution was similar in women with recurrent spontaneous abortion and controls, it is suggested that maternal HLA-E polymorphism per se does not play any role in the pathogenesis of this disorder of pregnancy.     

The factor V Leiden mutation in Japanese couples with recurrent spontaneous abortion.

Thrombosis of placental vessels can be a major cause of recurrent spontaneous abortion (RSA). The factor V Leiden (FVL) mutation, a single point mutation in the factor V gene, is the most common genetic predisposition to thrombosis in European countries and the United States. However, even among Caucasian populations, the association between the FVL mutation and RSA is still controversial. The objectives of the present study were to investigate the prevalence of the FVL mutation in Japanese women who have experienced RSA and to clarify the contribution of the FVL mutation to recurrent miscarriages. A total of 52 Japanese women with a history of three or more consecutive idiopathic first trimester miscarriages and 41 of their male partners were studied. The control group consisted of 55 parous women without obstetric complications. Peripheral blood cell DNA was examined for the presence of the FVL alleles by polymerase chain reaction with Mnl I restriction fragment length polymorphisms. None of the 52 women with RSA and the 41 partners carried the mutation. We also found no subject carrying the FVL alleles in the control group. These results suggest that the FVL alleles are not concentrated in women with RSA at least to clinically significant levels and that there is no apparent association between the FVL mutation and RSA in our Japanese population.     

Prevention of recurrent spontaneous abortion by intravenous immunoglobulin: a double-blind placebo-controlled study

The aim of this study was to evaluate the therapeutic efficacy of intravenous immunoglobulin (IVIG) in the prevention of recurrent spontaneous abortion (RSA). In a double-blind, randomized, placebo-controlled study, 41 women with a history of unexplained recurrent spontaneous abortion were treated with IVIG or saline infusions during pregnancy. The birth of a child was considered a successful outcome. The overall success rate was 77% in the IVIG group compared with 79% in the placebo group. For women with primary RSA the success rates were 82 (IVIG) and 89% (placebo), and for women with secondary RSA the rates were 73 (IVIG) and 70% (placebo). We found no statistically significant difference in treatment results between IVIG and placebo.     

Increased natural killer cell cytotoxicity and IL-2 production in recurrent spontaneous abortion

PROBLEM: To determine whether natural killer (NK) cells cytotoxicity in peripheral blood is altered in patients with a history of recurrent spontaneous abortion (RSA); also, if there is any correlation between cytokine production and NK cytotoxicity. METHOD OF STUDY: In this case-control study, 21 patients with RSA within 24 hr of the last abortion (group I), and 32 pregnants with no history of abortion (group II) were surveyed. NK cell cytotoxicity was evaluated by flow cytometry, and IL-2, IL-10, transforming growth factor beta1 were measured in cell culture supernatant by ELISA method. RESULTS: Group I showed higher NK cytotoxicity than group II at all of effector to target (E:T) ratios (P < or = 0.045).The correlation between production of IL-2 and NK cytotoxicity was positively significant (R = 0.350, P = 0.001). Group I had significantly higher levels of IL-2 than group II (P = 0.001). In group II, the production of IL-10 by peripheral blood mononuclear cells was higher than group I (P = 0.002). CONCLUSION: Increased NK cell cytotoxicity and high level of IL-2 may be considered as a risk factor for RSA.     

Endocrine abnormalities during the follicular phase in women with recurrent spontaneous abortion.

The frequency of endocrine abnormalities during the follicular phase in non-pregnant women with a history of recurrent abortion was investigated in a case-control study. A total of 42 consecutive women with recurrent spontaneous abortion (three or more consecutive abortions, mean +/- SD: 3.9 +/- 1.1 range 3-8) with no parental chromosome rearrangement or uterine abnormality were studied during the early follicular phase under standardized conditions. Serum concentrations of follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin, androstenedione, testosterone, dehydroepiandro-stenedione, 17-OH-progesterone, oestradiol, progesterone and thyroid stimulating hormone (TSH) were measured by commercially available radioimmunoassays. Controls were 42 nulligravid females with tubal or male factor infertility without miscarriage. Mean (SD) concentrations of prolactin and androstenedione were 14.2 +/- 6.7 ng/ml versus 10.5 +/- 3.5 ng/ml (95% CI 0.8-6.1) and 2.3 +/- 0.9 ng/ml versus 1.7 +/- 0.6 ng/ml (95% CI 0.2-0.9) in the study and control groups respectively. The other endocrine parameters were comparable in both groups. Obesity [BMI weight (kg)/height (m2) > or = 25] was more prevalent (23 versus 5 women, P = 0.0001) in the study than the control group. Recurrent spontaneous abortion is associated with abnormalities in prolactin and androgen secretion during the follicular phase, suggesting an endocrine aetiology in this disorder. Reduction of body weight and correction of hyperprolactinaemia and of hyperandrogenism may reduce the rate of miscarriage in a subsequent pregnancy in these women.     

T辅助细胞、NK细胞与原因不明复发性自然流产关系的研究进展

目前母-胎界面的免疫耐受机制是国内外的研究热点之一,URSA所表现的母-胎界面免疫耐受异常与T辅助细胞及NK细胞有密切的关系。本文首先对T辅助细胞和NK细胞的免疫状态、免疫耐受机制以及它们与URSA之间的关系进行了阐述,最后对目前与二者有关的URSA的主动免疫治疗研究进展作一综述。     

淋巴细胞主动免疫治疗母-胎免疫识别低下型反复性流产疗效分析

目的分析淋巴细胞主动免疫疗法治疗母-胎免疫识别低下型反复性流产（RSA）的临床疗效和作用机制。方法以临床筛查封闭抗体确诊为母-胎免疫识别低下型RSA未孕患者86例为研究对象,采用淋巴细胞主动免疫疗法治疗,将妊娠患者与同期不明原因反复性自然流产（URSA）已孕患者治疗情况对比观察疗效,对母-胎免疫识别低下型RSA患者治疗后不同归向原因进行对比分析该方法的作用机制。结果治疗后妊娠56例,妊娠成功51例,成功率91.07%,与对照组比较P〈0.01,主动免疫治疗疗效与患者年龄、反复流产次数有相关性,与注射淋巴细胞密度无相关性。结论母-胎免疫低下型RSA患者宜早期治疗,淋巴细胞主动免疫疗法是治疗母-胎免疫识别低下型RSA的有效方法。     

Ultrasonographic detection of a live fetus in recurrent spontaneous abortion during the first trimester

To examine whether recurrent spontaneous abortion (RSA) canbe distinguished from repeated sporadic spontaneous abortion,the clinical course of 38 cases with three or more consecutiveand unexplained first trimester RSAs were retrospectively investigatedin this study. For comparison with controls, the clinical coursewas examined of 38 fertile females, who had had sporadic abortions.In 19 (50%) RSAs and 6 (16%) controls, fetal cardiac activitywas demonstrated by ultrasound during the course of pregnancy.The rate of detection of live fetus during pregnancy or at 8weeks ± 7 days gestation, was significantly greater inthe RSA group compared to the control. The rate of vaginal bleedingbefore spontaneous abortion was significantly less in the RSAgroup than in the control group. There was no difference betweenthe two groups in age or gestational age at spontaneous abortion.The patients with RSA were all examined for antiphospholipidantibodies in their sera and these were detected in eight ofthem. However, there was no difference in the rate of positivefetal cardiac activity between the RSA patients who tested positiveor negative for antibody. These results reveal that the clinicalcourse of RSA is very different from the course of sporadicabortion. Although sporadic abortion is a common complicationof pregnancy, RSA is not a random repeated abortion, but rathera separate disease from sporadic abortion in normal fertilefemales.