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19000对复发性自然流产夫妇的染色体异常:一项多中心研究。

Chromosomal abnormalities of 19,000 couples with recurrent spontaneous abortions: a multicenter study.

作者信息

Park Seo-Jin, Min Ji-You, Kang Jeom-Soon, Yang Byung-Guk, Hwang Seung-Yong, Han Sung-Hee

机构信息

Department of Laboratory Medicine, Ajou University School of Medicine, Suwon, Republic of Korea.

Division of Biotechnology, Invites BioCore Co. Ltd., Yongin, Republic of Korea; Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, Republic of Korea.

出版信息

Fertil Steril. 2022 May;117(5):1015-1025. doi: 10.1016/j.fertnstert.2022.01.011. Epub 2022 Feb 23.

Abstract

OBJECTIVE

To investigate the demographic data and karyotypes of 19,000 couples who experienced recurrent spontaneous abortion (RSA).

DESIGN

A cross-sectional study of 19,000 couples.

SETTING

Five hospitals.

PATIENT(S): A total of 19,000 couples experiencing RSA.

INTERVENTION(S): Not applicable.

MAIN OUTCOME MEASURE(S): Cytogenetic analysis of blood lymphocytes.

RESULT(S): A total of 844 couples (4.44%) showed chromosomal aberrations in either partner. Females were more likely to have chromosomal aberrations. The mean age of females and males with chromosomal aberrations was younger than that of females and males without chromosomal aberrations. Interestingly, sex and age distribution varied significantly depending on the subtypes of chromosomal aberrations. We detected 324 balanced translocations, including 223 novel ones. They were distributed across all chromosomes; the frequency of balanced translocations decreased according to the numerical order of autosomes (strong negative correlation; r = -0.84). Individuals with balanced translocations were younger than other groups. All 58 inversions, including 25 novel ones, were detected in autosomes; the negative correlation also existed. Thirteen Robertsonian translocations, 5 deletions, and 3 duplications were detected. Six types of Turner variants, triple X mosaicism, and mosaic Down syndrome were detected in females; Klinefelter variants and mosaic XYY syndrome were detected in males. Marker chromosomes at various mosaic levels and 7 different complex chromosomal rearrangements were also observed.

CONCLUSION(S): Patients who experienced RSA induced by chromosomal aberrations experienced miscarriages at a younger age. Significant correlations existed between the patients' age or sex and the subtypes of chromosomal aberrations. This study detected several chromosomal abnormalities associated with RSA, including various novel aberrations.

摘要

目的

调查19000对经历复发性自然流产(RSA)夫妇的人口统计学数据和核型。

设计

对19000对夫妇进行的横断面研究。

地点

五家医院。

患者

总共19000对经历RSA的夫妇。

干预措施

不适用。

主要观察指标

血液淋巴细胞的细胞遗传学分析。

结果

共有844对夫妇(4.44%)一方或双方存在染色体畸变。女性更易出现染色体畸变。有染色体畸变的女性和男性的平均年龄低于无染色体畸变的女性和男性。有趣的是,性别和年龄分布因染色体畸变亚型的不同而有显著差异。我们检测到324例平衡易位,其中包括新发现的223例。它们分布于所有染色体;平衡易位的频率按照常染色体的数字顺序降低(强负相关;r = -0.84)。有平衡易位的个体比其他组更年轻。所有58例倒位,包括新发现的25例,均在常染色体中检测到;也存在负相关。检测到13例罗伯逊易位、5例缺失和3例重复。在女性中检测到6种特纳氏变异、XXX嵌合体和嵌合型唐氏综合征;在男性中检测到克氏变异和嵌合型XYY综合征。还观察到不同嵌合水平的标记染色体和7种不同的复杂染色体重排。

结论

因染色体畸变导致RSA的患者流产时年龄更小。患者的年龄或性别与染色体畸变亚型之间存在显著相关性。本研究检测到几种与RSA相关的染色体异常,包括各种新的畸变。

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