168例胚胎停育患者绒毛组织染色体核型分析

Karyotype analysis of chorionic villi tissue in 168 cases of pregnant women suffered from embryo loss

目的通过对胚胎停育患者绒毛组织染色体核型分析,探讨胚胎停育和染色体异常的关系,以及基层医院开展的意义。方法收集168例胚胎停育患者胚胎绒毛组织,采用机械剪碎方法直接进行原代细胞培养,制备染色体并进行G显带核型分析。结果168例胚胎停育患者胚胎绒毛组织体外培养成功165例,成功率98.21%。165例标本中染色体异常核型90例,占54.55%。低龄孕妇与高龄孕妇绒毛组织染色体异常率分别为53.17%和58.97%,2组异常核型异常率差异比较无统计学意义(χ^2=0.404,P>0.05)。但2组间异常染色体分布呈现不均匀态势,高龄孕妇异常核型主要为常染色体三体,常染色体三体异常占比高龄孕妇与低龄孕妇比较差异具有统计学意义(χ^2=20.117,P<0.05)。自然受孕与辅助生殖受孕后自然流产的染色体异常率分别为56.31%和53.23%,2者比较差异无统计学意义(χ^2=0.181,P>0.05)。结论染色体异常是胚胎停育的主要原因,其异常核型发生率以及分布特点的不同具有临床意义。

Objective By simple and convenient chorionic villus cultivation and karyoty ping,to analyze the abnormal karyotype incidence of abortion villus,and to discuss the clinical value of karyotyping.Methods One hundred and sixty eight cases of abortion villus tissue were collected,and cell culture were performed by mechanical shear method directly,not by collagenase or trypsin digestion,followed conventional G banding and karyotyping.Results One hundred and sixty five cases were cultured successfully among total 168 cases culturing,the success rate of cultivation was 98.21%.Ninety cases abnormal karyotype were detected.The abnormal karyotype ratio of the younger and older pregnant women were 53.17%and 58.97%,respectively.There were no significant difference between two groups(χ^2=0.404,P>0.05).However,the distribution of abnormal chromosomes between the two groups was not uniform.The abnormal karyotypes of older pregnant women were mainly autosomal trisomy.The proportion of autosomal trisomy abnormalities was significantly different between older pregnant women and younger pregnant women(χ^2=20.117,P<0.05).The abnormal karyotype ratio of the damaged embryo which conceived naturally and in vitro fertilization were 56.31%and 53.23%respectively.There were no significant difference between two groups(χ^2=0.181,P>0.05).Conclusion The chromosomal abnormality is a major cause of early embryo damage,the different ratio and distribution of abnormal chromosome in different maternal group reflected significant clinical value.