复发性自然流产夫妇的病因分析

发布时间：2018-01-17 21:20

  本文关键词：复发性自然流产夫妇的病因分析　出处：《中华妇幼临床医学杂志(电子版)》2016年04期 　论文类型：期刊论文

  更多相关文章： 流产 习惯性 病因 染色体障碍 免疫 不明原因

【摘要】：目的探讨复发性自然流产(RSA)的相关病因。方法选择2014年12月至2015年11月于四川大学华西第二医院生殖内分泌科和遗传优生科就诊的212对(424例)RSA夫妇的临床病历资料为研究对象。根据女方RSA发生次数,将这212对RSA夫妇分为2次RSA组(157对,314例)与≥3次RSA组(55对,110例)。收集212对RSA夫妇的年龄,女方月经史,生育史,流产情况(流产次数、时间及清宫次数),以及双方家族史等基本资料。对RSA夫妇双方进行外周血染色体核型分析,女方子宫超声检查、内分泌功能检查、免疫系统功能检查及女方弓形体病,风疹、巨细胞、单纯疱疹病毒(TORCH)血清学定量检测,以及男方精液常规检查等,筛查RSA病因。两组RSA夫妇的年龄等基本临床资料比较,差异无统计学差异(P0.05)。本研究遵循的程序符合四川大学华西第二医院人体试验委员会所制定的伦理学标准,得到该委员会批准。结果1本研究212对(424例)RSA夫妇中,共计检出染色体异常者为37例,检出异常率为8.7%(37/424),其中女方染色体异常者为27例,男方异常者为10例。女方子宫解剖结构异常者为23例(10.8%,23/212),内分泌功能异常者为60例(28.2%,60/212),生殖道感染者为16例(7.5%,16/212),免疫系统功能异常者为44例(20.7%,44/212)。男方精液数量或质量异常者为20例(9.4%,20/212)。本研究212对RSA夫妇中,76对(35.8%,76/212)上述因素均未见异常。部分RSA夫妇同时合并上述多种因素异常。2两组RSA夫妇染色体异常检出率比较,差异无统计学意义(χ2=1.470,P=0.225),但≥3次RSA组夫妇染色体易位核型检出率(7.3%,8/110)显著高于2次RSA组(1.6%,5/314),二者比较,差异有统计学意义(χ2=7.036,P=0.008)。≥3次RSA组女方子宫解剖结构异常检出率(18.2%,10/55)亦显著高于2次RSA组(8.3%,13/157),二者比较,差异有统计学意义(χ2=4.129,P=0.042)。≥3次RSA组不明原因RSA夫妇所占比例(21.8%,12/55)显著低于2次RSA组(40.8%,64/157),二者比较,差异亦有统计学意义(χ2=6.358,P=0.012)。两组女方内分泌功能异常、生殖道感染、免疫系统功能异常及男方精液异常检出率比较,差异均无统计意义(P0.05)。结论 RSA病因复杂,可由一种或多种因素联合所致,主要表现为内分泌功能异常及免疫系统功能异常。RSA患者中不明原因RSA所占比例仍较大,有关RSA病因筛查手段仍有待进一步提高。
[Abstract]:Objective to investigate the recurrent spontaneous abortion (RSAs). Methods from December 2014 to November 2015, 212 pairs were selected from the Department of Reproductive Endocrinology and the Department of genetic eugenics, Huaxi second Hospital, Sichuan University. The clinical records of the couple of RSA were studied. According to the frequency of occurrence of female RSA. The 212 RSA couples were divided into two groups: RSA group (n = 314) and RSA group (n = 55). The age and menstrual history of two RSA couples were collected. The basic data of birth history, abortion condition (abortion frequency, time, times of abortion, and family history of both parties). Karyotype analysis of peripheral blood chromosomes and ultrasound examination of the woman were carried out in the peripheral blood of RSA couples. Endocrine function examination, immune system function test and serological quantitative examination of toxoplasmosis, rubella, giant cell, herpes simplex virus TORCHand routine examination of male semen, etc. To screen the etiology of RSA. To compare the basic clinical data such as age of the two groups of RSA couples. The procedure followed in this study was in line with the ethical standards formulated by the Human body Test Committee of the West China second Hospital of Sichuan University. Results (1) of the 212 couples with RSA, 37 were detected chromosome abnormalities, and the abnormal rate was 8.7 / 424). There were 27 cases of chromosomal abnormality in women, 10 cases in men, and 23 cases in abnormal anatomic structure of uterus in 23 cases (10.8% / 212). There were 60 cases with abnormal endocrine function and 16 cases with genital tract infection. 44 cases with abnormal immune system and 20 cases with abnormal quantity or quality of semen were found. In this study, 76 out of 212 RSA couples were found to be 35. 8%. 76 / 212) none of the above factors were abnormal. Some RSA couples combined with the above mentioned factors. 2 the detection rate of chromosomal abnormalities in the two groups of RSA couples were compared. There was no significant difference (蠂 ~ 2 ~ 2 ~ (1.470)), but the positive rate of chromosome translocation in couples with RSA 鈮，

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