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607例特纳综合征患者的临床表现及细胞遗传学分析

[Clinical manifestation and cytogenetic analysis of 607 patients with Turner syndrome].

作者信息

Zheng Jiemei, Liu Zhiying, Xia Pei, Lai Yi, Wei Yangjun, Liu Yanyan, Chen Jiurong, Qin Li, Xie Liangyu, Wang He

机构信息

Department of Prenatal Diagnosis Center; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China.

出版信息

Zhonghua Yi Xue Yi Chuan Xue Za Zhi. 2017 Feb 10;34(1):61-64. doi: 10.3760/cma.j.issn.1003-9406.2017.01.014.

Abstract

OBJECTIVE

To explore the correlation between cytogenetic findings and clinical manifestations of Turner syndrome.

METHODS

607 cases of cytogenetically diagnosed Turner syndrome, including those with a major manifestation of Turner syndrome, were analyzed with conventional G-banding. Correlation between the karyotypes and clinical features were analyzed.

RESULTS

Among the 607 cases, there were 154 cases with monosomy X (25.37%). Mosaicism monosomy X was found in 240 patients (39.54%), which included 194 (80.83%) with a low proportion of 45,X (3 ≤ the number of 45, X ≤5, while the normal cells ≥ 30). Structural X chromosome abnormalities were found in 173 patients (28.50%). A supernumerary marker chromosome was found in 40 cases (6.59%). Most patients with typical manifestations of Turner syndrome were under 11 years of age and whose karyotypes were mainly 45,X. The karyotype of patients between 11 and 18 years old was mainly 45,X, 46,X,i(X)(q10) and mos45,X/46,X,i(X)(q10), which all had primary amenorrhea in addition to the typical clinical manifestations. The karyotype of patients over 18 years of age were mainly mosaicism with a low proportion of 45,X, whom all had primary infertility. 53 patients had a history of pregnancy, which included 48 with non-structural abnormalities of X chromosome and 5 with abnormal structure of X chromosome.

CONCLUSION

Generally, the higher proportion of cells with an abnormal karyotype, the more severe were the clinical symptoms and the earlier clinical recognition. Karyotyping analysis can provide guidance for the early diagnosis of Turner syndrome, especially those with a low proportion of 45,X.

摘要

目的

探讨特纳综合征细胞遗传学检查结果与临床表现之间的相关性。

方法

对607例经细胞遗传学诊断的特纳综合征患者(包括有特纳综合征主要临床表现的患者)进行常规G显带分析。分析核型与临床特征之间的相关性。

结果

607例患者中,X单体型有154例(25.37%)。X染色体嵌合单体型见于240例患者(39.54%),其中194例(80.83%)45,X比例较低(45,X细胞数为3至5个,正常细胞数≥30个)。173例患者(28.50%)存在X染色体结构异常。40例患者(6.59%)发现有额外的标记染色体。大多数有特纳综合征典型表现的患者年龄在11岁以下,其核型主要为45,X。11至18岁患者的核型主要为45,X、46,X,i(X)(q10)和mos45,X/46,X,i(X)(q10),除典型临床表现外均有原发性闭经。18岁以上患者的核型主要为45,X比例较低的嵌合体,均有原发性不孕。53例患者有妊娠史,其中48例X染色体无结构异常,5例X染色体结构异常。

结论

一般来说,核型异常细胞比例越高,临床症状越严重,临床确诊越早。核型分析可为特纳综合征的早期诊断提供指导,尤其是对于45,X比例较低的患者。

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