不同年龄和流产次数的复发性流产患者绒毛染色体核型分析

目的:了解复发性自然流产胚胎染色体异常发生情况。方法:2008年1月至2011年12月,在我院诊治并成功行绒毛染色体核型分析的自然流产患者235例,根据自然流产次数分为复发性流产组(125例)和偶发性流产组(110例)。比较两组绒毛染色体异常发生率和类型的差异,不同流产次数的胚胎染色体异常发生情况,以及不同年龄患者绒毛染色体异常的发生情况。结果:复发性流产组,绒毛染色体异常发生率显著低于偶发性自然流产组(47.2%vs 70.9%,P<0.05)。复发性流产组中三体占异常染色体的66.1%(39/59),显著高于偶发性流产组(44.8%,35/78)(P<0.05)。随着自然流产次数的增加,绒毛染色体异常发生率降低,差异有统计学意义(χ2=15.266,P=0.004)。复发性流产组中,年龄≥35岁者的绒毛染色体异常发生率明显高于年龄<35岁者(60.9%vs39.2%,P<0.05)。偶发性自然流产组中,年龄≥35岁者的绒毛染色体异常发生率亦明显高于年龄<35岁者(88.9%vs 62.2%,P<0.05)。结论:胚胎染色体异常是引起复发性流产的一个重要原因,随着流产次数的增加,流产胚胎染色体异常的发生率降低。无论是复发性流产还是偶发性流产,高龄均是引起胚胎染色体异常的高危因素。

Effect of maternal age and miscarriage number on karyotype analysis of chorionic villus in recurrent spontaneous abortion

Objective:To investigate the chromosomal aberration in the abortus of recurrent spontaneous abortion.Methods:From Jan.2008 to Dec.2011,chromosomal analysis was performed on products of conception of 235 pregnancies with early pregnancy loss.The frequency and type of chromosomal anomalies in recurrent spontaneous abortion and sporadic abortion were compared.The frequency of embryonic chromosomal anomalies in relation to the number of miscarriage were analyesd.Results:Chromosomal abnormality rate in recurrent spontaneous abortion group was lower compared with sporadic abortion group(47.2% vs 70.9%,P<0.05).The frequency of trisomy in recurrent spontaneous abortion group was higher than that of sporadic abortion group(66.1% vs 44.8%,P<0.05).The frequency of abnormal embryonic karyotypes significantly decreased with the number of spontaneous abortion(χ2=15.266,P=0.004).The abnormal embryonic karyotype in women aged ≥35 years old was higher than that in women aged<35 years old(P<0.05).Conclusion:Chromosomal anomaly is a major reason of recurrent spontaneous abortion.The frequency of abnormal embryonic karyotype significantly decreases with the number of abortion.Advancing maternal age is a risk factor for abnormal embryonic karyotype.