本文關(guān)鍵詞：復(fù)發(fā)性自然流產(chǎn)夫婦的病因分析　出處：《中華婦幼臨床醫(yī)學(xué)雜志(電子版)》2016年04期 　論文類型：期刊論文

  更多相關(guān)文章： 流產(chǎn) 習(xí)慣性 病因 染色體障礙 免疫 不明原因

【摘要】：目的探討復(fù)發(fā)性自然流產(chǎn)(RSA)的相關(guān)病因。方法選擇2014年12月至2015年11月于四川大學(xué)華西第二醫(yī)院生殖內(nèi)分泌科和遺傳優(yōu)生科就診的212對(duì)(424例)RSA夫婦的臨床病歷資料為研究對(duì)象。根據(jù)女方RSA發(fā)生次數(shù),將這212對(duì)RSA夫婦分為2次RSA組(157對(duì),314例)與≥3次RSA組(55對(duì),110例)。收集212對(duì)RSA夫婦的年齡,女方月經(jīng)史,生育史,流產(chǎn)情況(流產(chǎn)次數(shù)、時(shí)間及清宮次數(shù)),以及雙方家族史等基本資料。對(duì)RSA夫婦雙方進(jìn)行外周血染色體核型分析,女方子宮超聲檢查、內(nèi)分泌功能檢查、免疫系統(tǒng)功能檢查及女方弓形體病,風(fēng)疹、巨細(xì)胞、單純皰疹病毒(TORCH)血清學(xué)定量檢測(cè),以及男方精液常規(guī)檢查等,篩查RSA病因。兩組RSA夫婦的年齡等基本臨床資料比較,差異無統(tǒng)計(jì)學(xué)差異(P0.05)。本研究遵循的程序符合四川大學(xué)華西第二醫(yī)院人體試驗(yàn)委員會(huì)所制定的倫理學(xué)標(biāo)準(zhǔn),得到該委員會(huì)批準(zhǔn)。結(jié)果1本研究212對(duì)(424例)RSA夫婦中,共計(jì)檢出染色體異常者為37例,檢出異常率為8.7%(37/424),其中女方染色體異常者為27例,男方異常者為10例。女方子宮解剖結(jié)構(gòu)異常者為23例(10.8%,23/212),內(nèi)分泌功能異常者為60例(28.2%,60/212),生殖道感染者為16例(7.5%,16/212),免疫系統(tǒng)功能異常者為44例(20.7%,44/212)。男方精液數(shù)量或質(zhì)量異常者為20例(9.4%,20/212)。本研究212對(duì)RSA夫婦中,76對(duì)(35.8%,76/212)上述因素均未見異常。部分RSA夫婦同時(shí)合并上述多種因素異常。2兩組RSA夫婦染色體異常檢出率比較,差異無統(tǒng)計(jì)學(xué)意義(χ2=1.470,P=0.225),但≥3次RSA組夫婦染色體易位核型檢出率(7.3%,8/110)顯著高于2次RSA組(1.6%,5/314),二者比較,差異有統(tǒng)計(jì)學(xué)意義(χ2=7.036,P=0.008)。≥3次RSA組女方子宮解剖結(jié)構(gòu)異常檢出率(18.2%,10/55)亦顯著高于2次RSA組(8.3%,13/157),二者比較,差異有統(tǒng)計(jì)學(xué)意義(χ2=4.129,P=0.042)�！�3次RSA組不明原因RSA夫婦所占比例(21.8%,12/55)顯著低于2次RSA組(40.8%,64/157),二者比較,差異亦有統(tǒng)計(jì)學(xué)意義(χ2=6.358,P=0.012)。兩組女方內(nèi)分泌功能異常、生殖道感染、免疫系統(tǒng)功能異常及男方精液異常檢出率比較,差異均無統(tǒng)計(jì)意義(P0.05)。結(jié)論 RSA病因復(fù)雜,可由一種或多種因素聯(lián)合所致,主要表現(xiàn)為內(nèi)分泌功能異常及免疫系統(tǒng)功能異常。RSA患者中不明原因RSA所占比例仍較大,有關(guān)RSA病因篩查手段仍有待進(jìn)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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