实用医学杂志 ›› 2020, Vol. 36 ›› Issue (21): 2937-2941.doi: 10.3969/j.issn.1006⁃5725.2020.21.010

• 临床研究 • 上一篇    下一篇

早期胚胎停育患者中绒毛染色体异常的相关因素分析

黄晓珍,刘明星,许培,李浩贤,欧妙娴,梁彩虹   

  1. 广州医科大学附属第三医院妇产科(广州510150)
  • 出版日期:2020-11-10 发布日期:2020-11-30
  • 通讯作者: 刘明星E⁃mail:mxliu_gzh@126.com
  • 基金资助:
    国家重点研发计划(编号:2018YFC10029002);广东省教育厅青年创新人才基金(编号:2017KQNCX165)

Related factors of villus chromosome abnormality of patients with early embryo⁃stopping

HUANG Xiao⁃zhen,LIU Mingxing,XU Pei,LI Haoxian,OU Miaoxian,LIANG Caihong#br#   

  1. Department of Obstetrics and Gynecolo⁃gy,the Third Affiliated Hospital of Guangzhou Medical University,Guangzhou 510150,China
  • Online:2020-11-10 Published:2020-11-30
  • Contact: LIU Mingxing E⁃mail:mxliu_gzh@126.com

摘要:

目的 探讨早期胚胎停育患者中胚胎染色体异常的分布及危险因素,有助于指导优生优育。方法 回顾性分析2016 年1 月至2019 年6 月于广州医科大学附属第三医院确诊为早期胚胎停育并行绒毛染色体分析的536例患者的临床资料,研究绒毛染色体异常的分布情况;采用Logistic 回归分析绒毛染色体异常的危险因素。结果(1)早期胚胎停育的绒毛染色体异常率为61.8%。染色体数目异常中常见三体、三倍体及(45,X)。染色体结构异常中常见缺失。三体中常见16三体及22⁃三体。(2)患者高龄是绒毛染色体异常的危险因素,而辅助生殖受孕是保护因素。≥ 35岁组的绒毛染色体数目异常、非整倍体、三体及复合三体的发生率均高于<35岁组(P<0.05)。辅助生殖受孕组的的染色体数目异常率、三倍体率均低于自然受孕组(P<0.05)。结论(1)胚胎染色体异常是早期胚胎停育的主要原因,以三体、三倍体及(45,X)较常见,三体中常见16、22⁃三体。(2)女性高龄与胚胎染色体异常率升高呈正相关;采用辅助生殖技术受孕不增加胚胎染色体异常的发生。

关键词: 胚胎停育, 染色体, 非整倍体, 高龄, 辅助生育, 自然受孕

Abstract:

Objective To explore the distribution of different types of chromosomal abnormality ofpatients diagnosed as embryo⁃stopping and analyze the risk factors leading to embryonic chromosome abnormality.Method To retrospectively analyze the clinical data of 536 patients diagnosed as embryo⁃stopping and treatedwith villus chromosome analysis in the Third Affiliated Hospital of Guangzhou Medical University from January2016 to June 2019 and analyze the distribution of villi chromosome abnormalities. Logistic regression analysis wasused to explore the risk factors of embryonic chromosomal abnormality. Results (1)The incidence of chromosomalabnormality in early embryo⁃stopping was 61.8%. Ttrisomy,triploid and(45,X)were the three common types ofabnormalities. Among the cases with abnormal chromosome structures,the more common type is deletion. Trisomy16(30.4%)and trisomy 22(21.9%)were the two more common in trisomy.(2)Advanced age was a risk factor forchromosomal abnormality,while assisted reproductive conception a protective factor. The incidence of abnormalchromosome number,aneuploidy,trisomy and compound trisomy in the group with age ≥ 35 were all significantlyhigher than those in the group with age <35(P < 0.05). Chromosomal abnormality rate and triploid rate of theassisted reproductive conception group were significantly lower than those of the natural conception group(P < 0.05).Conclusion Fetal chromosome abnormality is the main reason for early embryo⁃stopping. Trisomy and triploid and(45,X)are frequently⁃seen and among trisomies,trisomy 16 and trisomy 22 are the two more common. Age is pos⁃itively correlated with embryonic chromosome abnormality;assisted reproductive conception will not increase theincidence of embryonic chromosome abnormalities.

Key words: embryo?stopping, chromosome, aneuploid, advanced age, assisted reproduction, natural conception