自然流产患者胚胎染色体异常的危险因素分析

doi:10.3969/j.issn.2095-5340.2025.06.008

发育医学电子杂志

2025, Vol. 13

Issue (6): 455-461 DOI: 10.3969/j.issn.2095-5340.2025.06.008

临床遗传论著

自然流产患者胚胎染色体异常的危险因素分析

刘琳杨岩婷虎宁霍虎艳王芳

1. 兰州大学第二临床医学院，甘肃兰州 730000；2. 兰州大学第二医院生殖医学科，甘肃兰州 730000

Analysis of risk factors for embryonic chromosomal abnormalities in patients with spontaneous abortion

Liu Lin, Yang Yanting , Hu Ning, et al

1. the Second School of Clinical Medicine, Lanzhou University, Gansu, Lanzhou 730000, China; 2. Department of Reproductive Medicine, the Second Hospital of Lanzhou University, Gansu, Lanzhou 730000, China

摘要
相关文章
推荐阅读
Metrics

下载:

PDF (1239KB)
输出: BibTeX | EndNote (RIS)

摘要 【摘要】目的 探讨自然流产患者胚胎染色体异常的危险因素。方法采用回顾性研究方法选取 2019 年 9 月至 2024 年 11 月就诊于兰州大学第二医院生殖医学科的 923 例自愿接受胚胎组织染色体检测的自然流产患者作为研究对象，根据胚胎染色体结果将其分为异常组（n=513）和正常组（n=410）。分析 2 组的相关资料、胚胎染色体检测结果及其分布特征，并筛选自然流产患者胚胎染色体异常的危险因素。统计学方法采用独立样本 t 检验、Mann-Whitney U 检验、χ2 检验或 Fisher 确切概率法以及多因素Logistic 回归分析。结果在 513 例异常组患者中，累计检测出606 种不同的异常胚胎组织染色体类型，其中非整倍体、结构异常、嵌合体及多倍体的占比分别为 59.08%（358/606）、23.43%（142/606）、9.08%（55/606）和 8.42%（51/606）。异常组女性平均年龄高于正常组 [（31.50±4.22）岁与（30.63±3.90）岁，t=-3.256 ， P=0.001] ；异常组的血清同型半胱氨酸（homocysteine，HCY）、25- 羟基维生素 D3[25-hydroxyvitamin D3 ， 25-(OH)D3] 水平均低于正常组 [（10.41±4.29）μmol/L 与（11.15±6.86）μmol/L，（14.56±8.10）ng/ml 与（15.91 ±8.76）ng/ml，t 值分别为 2.003、2.426，P 值均 <0.05]。其余指标间差异均无统计学意义（P 值均 >0.05）。多因素 Logistic 回归分析结果显示，女性年龄升高（OR=2.041，95% CI ：1.469~2.836）、HCY水平降低（OR=0.973，95% CI ：0.947~1.000）和 25-(OH)D3 水平降低（OR=0.978，95% CI ：0.963~0.994）是影响胚胎染色体异常的独立风险因素。结论自然流产主要由胚胎染色体异常导致，女性高龄、HCY和 25-(OH)D3 水平降低会增加胚胎染色体异常的风险。

	服务
	把本文推荐给朋友
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章

关键词: 自然流产胚胎染色体异常拷贝数变异测序女性年龄影响因素分析 Logistic 回归分析

Abstract: 【Abstract 】 Objective To explore the risk factors for embryonic chromosomal abnormalities in patients with spontaneous abortion. Method A total of 923 patients with spontaneous abortion who visited the Department of Reproductive Medicine, the Second Hospital of Lanzhou University from September 2019 to November 2024 and voluntarily underwent karyotype testing of embryonic tissue chromosomes were retrospectively selected as the research subjects.They were divided into the abnormal group (n=513) and the normal group (n=410) according to the embryonicchromosome test results. The relevant data, embryonic chromosome test results and their distribution characteristics between the two groups were analyzed, and the risk factors for embryonic chromosomal abnormalities in patients with spontaneous abortion were identi?ed.Statistical methods were performed by independent samples t-test, Mann-Whitney U test, χ2 test or Fisher exact probability method, and multivariate Logistic regression analysis. Result Among the 513 patients in the abnormal group, a total of 606 instances of fetal chromosomal abnormalities were detected. The proportions of aneuploidy, structural abnormalities, chimeras, and polyploidy were 59.08% (358/606), 23.43% (142/606), 9.08% (55/606), and 8.42% (51/606), respectively. The average age of women in the abnormal group was higher than that in the normal group [(31.50±4.22) years vs (30.63 ±3.90) years, t=-3.256, P=0.001]. The levels of serum homocysteine (HCY) and 25-hydroxyvitamin D3 [25-(OH)D3] in the abnormal group were lower than those in the normal group [(10.41 ±4.29) μmol/L vs (11.15±6.86) μmol/L, (14.56±8.10) ng/ml vs (15.91 ±8.76) ng/ml, with t-values of 2.003 and 2.426, respectively, all P<0.05]. There were no statistically significant differences in other indicators (all P>0.05). Multivariate Logistic regression analysis showed that advanced maternal age (OR=2.041, 95% CI: 1.469-2.836), decreased HCY level (OR=0.973, 95% CI: 0.947-1.000), and decreased 25-(OH)D3 level (OR=0.978, 95% CI: 0.963- 0.994) were independent risk factors for embryonic chromosomal abnormalities. Conclusion Spontaneous abortion is mainly caused by embryonic chromosomal abnormalities. Advanced maternal age, decreased HCY level, and decreased 25-(OH)D3 level can increase the risk of embryonic chromosomal abnormalities.

Key words: Spontaneous abortion Embryonic chromosome abnormality Copy number variation sequencing Female age In?uencing factor analysis Logistic regression analysis

收稿日期: 2025-04-09 发布日期: 2025-11-30

基金资助: 国家自然科学基金（82460306 ）；甘肃省卫生健康行业科研项目（GSWSKY2024-04 ）；兰州市科技计划项目（2023-ZD-82 ）；兰州大学第二医院“萃英科技创新”计划项目（CY2022-MS-B03）

通讯作者: 王芳 E-mail: ery_fwang@lzu.edu.cn

引用本文:

刘琳杨岩婷虎宁霍虎艳王芳. 自然流产患者胚胎染色体异常的危险因素分析[J]. 发育医学电子杂志, 2025, 13(6): 455-461.
Liu Lin, Yang Yanting , Hu Ning, et al. Analysis of risk factors for embryonic chromosomal abnormalities in patients with spontaneous abortion. Journal of Developmental Medicine(Electronic Version), 2025, 13(6): 455-461.

链接本文:

http://www.fyyxzz.com/CN/10.3969/j.issn.2095-5340.2025.06.008 或 http://www.fyyxzz.com/CN/Y2025/V13/I6/455

[1]	李静刘嘉陈萍崔焱 . 初产妇分娩心理创伤的影响因素识别及防控策略探究[J]. 发育医学电子杂志, 2025, 13(6): 441-447,454.
[2]	刘恒郭婉茹蒋天从戚桂杰. 高龄孕妇产前诊断胎儿染色体异常结果特征分析[J]. 发育医学电子杂志, 2024, 12(5): 337-341,349.
[3]	马妍　李文. 早期自然流产绒毛发育影响因素的研究进展[J]. 发育医学电子杂志, 2016, 4(1): 57-61.
[4]	李雅丹　林新祝　黄静等. 早产儿喂养不耐受的影响因素与治疗策略[J]. 发育医学电子杂志, 2015, 3(4): 212-216.

[1]	Society of Neonatologist, Chinese Medical Doctor Association. Consensus recommendations on the prevention and early management of respiratory distress syndrome in preterm infants[J]. Journal of Developmental Medicine(Electronic Version), 2017, 5(3): 129 -131 .
[2]	Professional Committee of Respiratory, Society of Neonatologist, Chinese Medical Doctor Association. Clinical application recommendations for heated humidified high flow nasal cannula[J]. Journal of Developmental Medicine(Electronic Version), 2017, 5(3): 132 -135 .
[3]	YAN Jun, ZHU Xing-wang, SHI Yuan. Application progress of noninvasive ventilate technique for premature infants[J]. Journal of Developmental Medicine(Electronic Version), 2017, 5(3): 136 -140 .
[4]	GU Min-fang, YANG Chuan-zhong. Progress of intrapartum resuscitation for premature infants[J]. Journal of Developmental Medicine(Electronic Version), 2017, 5(3): 141 -145 .
[5]	LIU Shu-hua, SHEN Yue-bo, LIU Cui-qing, MA Li. The efficacy of pulmonary surfactant for pulmonary function in premature tension pneumothorax[J]. Journal of Developmental Medicine(Electronic Version), 2017, 5(3): 146 -151 .
[6]	GAO Xiao-hui, MAO Jian. Clinical features of non-oliguric hyperkalemia in extremely low birth weight infants[J]. Journal of Developmental Medicine(Electronic Version), 2017, 5(3): 152 -158 .
[7]	XIA Yao-fang, YANG Juan , TIAN Bao-li, et al. Value of amplitude-integrated electroencephalography in monitoring acute period of neonatal bilirubin encephalopathy and prognostic assessment[J]. Journal of Developmental Medicine(Electronic Version), 2017, 5(3): 159 -163 .
[8]	WANG Li-rong, SUN Xiao-yan, ZHU Ruo-xin, et al. Epidemiological investigation and analysis of women aged 40-55 years old with osteoporosis in Gansu province[J]. Journal of Developmental Medicine(Electronic Version), 2017, 5(3): 164 -167 .
[9]	CHEN Ru-yue, SHEN Yun-yan, CHEN Qing , et al. Five cases about Henoch-Schönlein purpura complicated with central nervous system injury in children and literatures review[J]. Journal of Developmental Medicine(Electronic Version), 2017, 5(3): 168 -171 .
[10]	ZHANG Ai-run, FANG Xiao-yi. Lung function testing of bronchopulmonary dysplasia for infants and children[J]. Journal of Developmental Medicine(Electronic Version), 2017, 5(3): 172 -176 .

Viewed

Full text

Abstract

Cited

Shared

Discussed