复发性流产患者流产后绒毛染色体核型分析

Karyotype analysis of villus chromosomes after abortion in patients with recurrent spontaneous abortion

目的分析复发性流产(RSA)患者流产后绒毛染色体核型。方法本研究于2017年4月~2019年4月采用简单随机抽样法抽取本院就诊并成功行绒毛染色体核型分析的自然流产患者137例为观察对象,依据自然流产次数,将自然流产次数在3次及以上的设为RSA组(n=80),将自然流产次数在2次及以下的设为偶发性流产组(n=57),比较两组患者绒毛染色体核型情况,异常率、异常类型及不同流产次数下的异常率情况。结果 RSA组80例患者中,绒毛染色体正常患者42例,占比为52.50%,异常患者38例,占比为47.50%。偶发性流产组57例患者中,绒毛染色体正常患者14例,占比为24.56%,异常染色体患者43例,占比为75.44%。RSA组绒毛染色体异常发生率低于偶发性流产组(P <0.05),在绒毛染色体异常类型中,在三体异常方面,RSA组高于偶发性流产组(P <0.05)。在三倍体、结构异常以及嵌合体类型异常中,两组无统计学差异(P> 0.05)。伴随自然流产次数的增加,绒毛染色体异常的发生率呈现降低趋势,且有统计学差异(P <0.05)。结论复发性流产的发生的主要原因是胚胎染色体,在流产次数增加的过程中,其异常发生率会逐渐降低。

Objective To analyze the karyotype of villus chromosomes after abortion in patients with recurrent spontaneous abortion(RSA). Methods In this experiment, 137 patients with spontaneous abortion who were treated at our hospital and successfully underwent karyotype analysis of villus chromosomes from April 2017 to April 2019 were selected as the observation subjects using the simple random sampling. According to the number of spontaneous abortions, those with 3 or more spontaneous abortions were considered as the RSA group(n=80), while those with 2 or less spontaneous abortions were considered as the accidental abortion group(n=57). The karyotype of villus chromosomes, abnormal rate, abnormal type, and abnormal rate of different abortion frequency were compared between the two groups of patients. Results Among the 80 patients in the RSA group, 42 patients had normal villus chromosomes, accounting for 52.50%;and 38 patients had abnormal villus chromosomes, accounting for 47.50%. Among the 57 patients in the accidental abortion group, 14 patients had normal villus chromosomes, accounting for 24.56%;and 43 patients had abnormal chromosomes, accounting for 75.44%. The incidence of abnormal villus chromosomes in the RSA group was lower than that in the accidental abortion group(P < 0.05). Among the types of abnormal villus chromosomes, the triploid abnormality was higher in the RSA group than in the accidental abortion group(P < 0.05). There was no statistical difference in the triploid, structural abnormalities, and chimera type abnormalities between the two groups(P > 0.05). With the increase in the number of spontaneous abortions, the incidence of abnormal villus chromosomes showed a decreasing trend, with statistical difference(P < 0.05). Conclusion The major cause for the occurrence of recurrent spontaneous abortion is the embryonic chromosome. In the process of increasing the number of abortions, its incidence of abnormalities will gradually decrease.