156例自然流产绒毛细胞培养及染色体核型分析

Cell culture and karyotype analysis of spontaneous abortion villi in 156 cases

目的探讨染色体核型分析在自然流产查因中的应用。方法选择2019年1—12月于南方医科大学附属小榄医院就诊的156例自然流产患者作为研究对象,对所有患者进行绒毛细胞培养与G显带核型分析,计算培养成功率,分析染色体异常检出率及主要异常类型。结果156例自然流产孕妇中绒毛培养成功144例,培养成功率为92.3%,其中28~34岁和35~40岁年龄段患者的标本培养成功率分别为96.1%(98/102)和85.2%(46/54);9例因染菌导致培养失败,3例因胚胎停育时间过长、标本活性差、细胞不贴壁导致培养失败。检出染色体异常70例,异常检出率为48.6%,其中常染色体非整倍体44例、性染色体非整倍体16例、三倍体7例、四倍体1例、染色体结构异常2例,异常核型以X单体〔22.9%(16/70)〕、16三体〔20.0%(14/70)〕、22三体〔15.7%(11/70)〕、21三体〔10.0%(7/70)〕和三倍体〔10.0%(7/70)〕为主。结论染色体异常是导致自然流产的重要原因,对流产绒毛进行染色体核型分析有助于查明自然流产的原因,以便指导患者以后的生育并进行必要的产前诊断。

Objective To investigate the application of karyotyping in detection of the causes for spontaneous abortion.Methods 156 patients of spontaneous abortion villi admitted in Xiao Lan Hospital Affiliated to Southern Medical University from January to December 2019 were selected as research objects.The villus cell culture and G-banding karyotype analysis were performed in all patients,the success rate of culture was calculated,the detection rate of chromosomal abnormalities and main types of abnormalities were analyzed.Results In156 patients of spontaneous abortion,144 cases of villus culture were successful,the success rate was 92.3%.Nine cases failed due to infection of bacteria,3 cases failed due to prolonged embryo suspension,poor specimen activity and non adherent cell culture.The success rates of specimen culture of 28-34 year old and 35-40 year old patients were 96.1%(98/102)and 85.2%(46/54).Forty-four cases were detected as autosomal aneuploidy,16 cases were sex chromosome aneuploidy,7 cases were triploidy,1 case was tetraploid and 2 cases were structural abnormality.The abnormal karyotypes were mainly X monomer[22.9%(16/70)],16 trisomy[20.0%(14/70)],22 trisomy[15.7%(11/70)],21 trisomy[10.0%(7/70)]and triploid[10.0%(7/70)].Conclusions Chromosomal abnormality is an important cause for spontaneous abortion.Karyotype analysis of abortion villi is helpful to identify the causes of spontaneous abortion and guide the patients who will be pregnant again and to make necessary prenatal diagnosis.