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目的:探讨脐血染色体异常与两种类型的胎儿生长受限之间的关系。方法:将2007年5月~2009年12月在湖北省妇幼保健院74例胎儿生长受限的病例分为两组:均称型FGR组和不均称型FGR组,对其进行脐血染色体核型分析并比较两组脐血染色体异常率。再将31例均称型胎儿生长受限的病例分为两组:合并胎儿畸形组与不合并胎儿畸形组,进一步比较两组脐血染色体异常率。结果:检出异常核型8例,染色体异常检出率为9.4%(8/74),其中均称型FGR组异常检出率为16.1%(5/31),不均称型FGR组检出率为7.0%(3/43),两者异常率无统计学差异。8例异常核型中,染色体数目异常6例,包括三倍体1例、18-三体2例、21-三体1例、13-三体1例、Turner综合征1例;染色体结构异常2例,包括染色体平衡异位1例,倒位1例。11例合并胎儿畸形的均称型FGR脐血染色体异常率为36.3%(4/11);20例未合并胎儿畸形均称型FGR脐血染色体异常率5.0%(1/20),两者异常率差异有统计学意义。结论:脐血染色体异常是均称型FGR的主要原因之一;染色体三体为脐血染色体主要异常核型;均称型FGR合并胎儿畸形较不合并胎儿畸形的脐血染色体异常风险增加。
Objective: To investigate the relationship between cord blood chromosomal abnormalities and two types of fetal growth restriction. Methods: From May 2007 to December 2009, 74 cases of fetal growth restriction in Hubei Maternal and Child Health Hospital were divided into two groups: normal-type FGR group and non-uniform-type FGR group, Karyotype analysis and comparison of two groups of cord blood chromosomal abnormalities rate. Then 31 cases of homozygous fetal growth restriction were divided into two groups: merger fetal malformation group and non-merger fetal malformation group, and further compare the two groups of cord blood chromosomal abnormality rate. Results: Eight cases of abnormal karyotype were detected, the detection rate of chromosomal abnormalities was 9.4% (8/74), of which the abnormal detection rate was 16.1% (5/31) in the type of FGR and the type of FGR Rate of 7.0% (3/43), the two abnormal rates no significant difference. Among the 8 cases of abnormal karyotype, there were 6 cases with abnormal chromosome number, including 1 case of triploid, 2 cases of 18-trisomy, 1 case of 21-trisomy, 1 case of 13-trisomy and 1 case of Turner’s syndrome. 2 cases, including 1 case of chromosomal balance ectopic and 1 case of inverted position. In 11 cases, the abnormality rate of chromosomal abnormalities in FGR was 36.3% (4/11). In 20 cases, the abnormal rate of chromosomal abnormalities in FGR was 5.0% (1/20), both of which were abnormal Rate difference was statistically significant. Conclusion: Umbilical cord chromosome abnormalities are one of the main causes of the FGR. The trisomy of the cord blood is the main abnormal karyotype of the cord blood. The risk of chromosome abnormalities in umbilical blood is increased if the FGR combined with fetal abnormalities is not associated with fetal abnormalities.