稽留流产患者染色体检查

Chromosome examination of missed abortion patients

目的 探讨稽留流产与染色体异常的关系,指导优生.方法 对象为2014年6月至2015年4月在天津市中心妇产科医院就诊稽留流产夫妇,共90对.采用静脉血淋巴细胞培养行染色体核型检查,并对其90例清宫绒毛通过高通量测序技术进行染色体检查.结果 90对夫妇外周血染色体异常者共7例,异常率为3.89％.其中相互平衡易位3例,罗氏易位2例,倒位2例.90例绒毛检测成功85例,检测成功率94.4％,其中染色体异常绒毛50例,包括数目异常39例,结构异常11例,总异常率为58.8％.此外,稽留流产复发组（≥2次）与首发组绒毛染色体异常率分别是61.7％和55.2％,两组比较P＞0.05.孕妇年龄≥35岁组绒毛染色体异常率71.1％,年龄＜35岁组45％,两组比较P＜0.05.结论 染色体异常是造成稽留流产的重要原因,绒毛染色体异常率与稽留流产次数无关,孕妇高龄是造成绒毛染色体异常的高危因素.

Objective To investigate the relationship between the missed abortion and chromosome abnormality and guide the healthy birth.Methods From June 2014 to April 2015 in Tianjin central hospital of gynecology and obstetrics,we examined venous blood from 90 missed abortion couples for chromosome karyotype by lymphocyte culture method and we also examined their chromosome karyotype of abortion villus samples by high-throughput sequencing technologies.Results Out of the 90 couples＇ blood chromosome examinations,7 were abnormal,and the abnormal rate was 3.89%,including 3 cases reciprocal translocation,2 cases robertsonian translocation and 2 cases inversion.Abortion villus samples from the same population were also checked,of which 85 cases succeeded,with the success rate of 94.4%.Among them,villi chromosome abnormalities were found in 50 cases,including 39 cases with abnormal chromosome numbers,11 cases with abnormal chromosome structure,and the total abnormal rate was 58.8%.In addition,the villi chromosome abnormality rate of patients with recurrent missed abortion （≥ 2 times） and first missed abortion were 61.7% and 55.2%,respectively,and the difference was not significant （P 〉 0.05）.The villi chromosome abnormality rate of pregnant women with age ≥ 35 years old was 71.1%,while the pregnant women with aged 〈 35 years old was 45% （P 〈 0.05）.Conclusions Chromosome abnormality is an important cause of missed abortion;villi chromosome abnormality rate has nothing to do with the number of missed abortion;pregnant woman with age ≥ 35 years old is risk factor of the villi chromosome abnormality.