胚外体腔穿刺术在早期产前诊断应用的初步探讨

目的：探讨胚外体腔穿刺术（coelocentesis)的方法及胚外体腔细胞用于产前诊断的可行性。方法：42例单胎妊娠拟终止妊娠的妇女，吸宫术前在B超阴道探头引导下穿刺胚胎的胚外体腔，取胚外体腔细胞，采用聚合酶链反应（Polymerase chain reaction,PCR)技术检测Y染色体上SRY（esx-determining region Y)基因，并以绒毛检测结果作为对照标准。结果：穿刺成功率为97．6％（41／42），抽出液体0．5－7ml，以绒毛检测结果作为标准，胚外体腔细胞SRY基因检测的准确率为90．0％（36／40）。其中21例女胎胚外体腔细胞检测结果全部与绒毛相符；19例绒毛检测为男胎者，有4例胚外体腔细胞结果不相符，男胎的准确率为78．9％（15／19）。结论：胚外体腔穿刺术是一简便手术方法。应用胚外体腔细胞进行产前诊断是可行的。但是，因胚外体腔细胞含少，在临床应用之前，需提高检测方法的敏感性，以提高检测的准确性。

A Srudy of prenatal diagnosis by ceolocentesis

Objective:To investigate the method of ceolocentesis,and the possibility of using celolomic cells for prenatal diagnosis.Methods:42 women with singleton pregnancy planed to terminate during 6-8 gestational weeks,the ceolocenteses were performed before uterine suction.SRY gene was detected by polymerase chain reaction(PCR)for both ceolomic cells and chorionic villi.The results of chorionic villi were as control criteria.Results:The successful rate of ceolocentesis was 97.6%(41/42).0.7-10ml ceolomic fluid was drawn out.The total concordent rate of SRY gene is 90.0%(36/40)between the samples of ceolomic cells and villi.In all 21 female embryos the detecting results were concordant.In male cases however,4 out of 19 were discordent,the concordent rate was 78.9%(15/19)for male.Conclusion: Ceolocentesis is an easy-performed method.Though ceolomic cells can be used for prenatal diagnosis,for the reason of small number of cells existing within ceolomic fluid,the sensitivity of detection should be increased in order to make diagnosis correctly before being used in patients.