流動育齡婦女稽留流產的病因分析及臨床意義

胡獻玉，喻蘭，梁錫陽，李延輝，胡桂貞

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流動育齡婦女稽留流產的病因分析及臨床意義

胡獻玉1a，喻蘭2，梁錫陽1b，李延輝1a，胡桂貞1a

[摘要]目的：探討流動育齡婦女稽留流產的病因機制以及臨床意義。方法：選取2013年5月-2015年5月來醫院就診的流動育齡婦女稽留流產患者共120例為觀察組，并選擇同期無自然流產史者行人工流產的流動育齡婦女正常孕婦100例為對照組。取2組的胚胎組織物標本，采用RT-PCR法檢測胚胎組織中支原體(UU)、衣原體(CT)的基因拷貝數，并對胚胎組織采用FISH技術進行染色體變異分析。結果：觀察組CT、UU以及CT+UU混合感染陽性率明顯高于對照組，差異有非常顯著性(P<0.01)。觀察組胎兒絨毛組織的染色體正常72例，占60.0%；染色體數目異常48例，異常率為40.0%；對照組胎兒絨毛組織的染色體正常89例，占89.0%；染色體數目異常11例，異常率為11.0%。觀察組胎兒絨毛組織的染色體異常率明顯高于對照組(P<0.01)。結論：孕婦CT感染、UU感染以及兩者的混合感染與稽留流產的發生密切相關，而胚胎染色體異常是稽留流產發生比較重要的因素。

[關鍵詞]稽留流產；病因;臨床意義；流動育齡婦女

Cause analysis and clinical significance of childbearing age women with missed abortionHUXian-yu,YULan,LIANGXi-yang,etal.(ShijieHospitalofDongguanCity,Guangdong513290,China)

【Abstract】Objective：To study the cause and clinical significance of childbearing age women with missed abortion.Methods:From May 2013 to May 2015,120 cases of childbearing age women with missed abortion were chosen as an observation group,and 100 cases of normal pregnant women,who had no history of spontaneous abortion and underwent induced abortion,were selected as a control group.The embryonic tissue specimens of the two groups were collected.The gene copy number of UU and CT in the embryonic organization was detected by RT-PCR in the two groups,and chromosome mutation analysis was carried out by FISH.Results:The infection positive rates of CT,UU and CT+UU mixed in the observation group were significantly higher than those in the control group(P<0.01).The number of normal fetal villi tissue chromosome in the observation group was 72(60.0%) and the abnormal chromosome number was 48(40.0%).Normal fetal villi tissue chromosome in the control group was 89 (89.0%) and the abnormal chromosome number was 11 (11.0%).The chromosome abnormality rate of fetal villi tissue in the observation group was obviously higher than that of the control group(P<0.01).Conclusion:The infection of CT,UU and CT + UU mixed of pregnant women is closely related with the occurrence of missed abortion.Embryo chromosome abnormality is one of the more important factors of missed abortion.

【Key words】Missed abortion; Cause of disease; Clinical significance; Migrant women of childbearing age

稽留流產是又稱過期流產或死胎不下，指胚胎或胎兒死亡滯留宮腔內尚未自然排出者,是自然流產的特殊情況之一，一般多在癥狀產生后1～2個月內排出。因此，皆規定胚胎停止發育后2個月尚未自然排出者，稱為稽留流產。稽留流產不僅對孕婦精神上造成很大影響，更重要的是對身體造成極大有危害。造成稽留流產的原因較多，較為復雜，呈逐年上升趨勢，病因診斷不明確，目前除B超形態學診斷外，仍缺乏靈敏度和特異度均高的稽留流產診斷指標及與病理學改變的原因分析。因此，研究稽留流產發病機制、病理學改變及原因分析、尋找早期診斷稽留流產的標記物，以利于臨床早期檢測及發現，進而流產的發展過程，對控制流產的發展有著十分重要的意義[1-2]。……