复发性流产与染色体核型异常的关系及其干预措施分析
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摘要
目的探讨复发性流产与染色体核型分布的关系及其干预措施。方法选取2016年1月-2017年12月我院门诊诊治的复发性流产患者90例,按照随机数字法分为研究组(n=45)和对照组(n=45),对两组患者染色体核型分布情况进行观察,对照组患者应用常规干预的方法,研究组患者在对照组的基础上应用系统心理干预的措施。观察两组患者干预前后抑郁自评量表(SDS)、焦虑自评量表(SAS)评分的变化以及干预效果的差异,并观察患者复发性流产与染色体核型分布的关系。结果染色体核型分布情况,患者复发性流产主要与患者染色体相互易位、倒位、特纳氏综合征(Turner)、罗氏易位以及数目异常有着密切的关系(P<0.05);SDS、SAS评分方面,干预前两组患者的SDS、SAS评分无明显差别(P>0.05),干预后研究组和对照组患者评分得到改善,并且研究组的评分明显低于对照组患者(P<0.05);干预效果方面,研究组患者应用系统心理的干预效果明显优于对照组患者(P<0.05)。结论复发性流产与夫妇染色体核型分布有着密切关系,若至少一方存在异常,应及时进行必要的产前诊断,进而采取合适的干预措施,降低患者心理忧郁的发生率,提高临床干预效果,从而能够取得较为满意的妊娠结局,临床上应当进一步推广应用。
Objective:To investigate the relationship between recurrent spontaneous abortion and chromosome karyotype distribution and the intervention measures. Methods:90 patients with recurrent spontaneous abortion from January 2016-2017 year in December in our hospital outpatient treatment of patients,were randomly divided into study group(n=45)and control group(n=45),the two groups of patients with chromosome distribution were observed,the control group were treated with conventional methods of intervention,application system research group on the basis of psychological intervention in patients the control group on measures. The changes of the self rating Depression Scale(SDS),self rating Anxiety Scale(SAS)and the effect of intervention between the two groups before and after intervention were observed,and the relationship between the effect of intervention and the distribution of chromosomal karyotype were observed. Results:The results of karyotype distribution of patients with recurrent spontaneous abortion patients with chromosome translocation and inversion,Turner′s syndrome(Turner),and Y Robertsonian translocation,Y has a close relationship(P<0.05);SDS,SAS score before the intervention,two groups of patients with SDS and SAS score significant differences(P>0.05),intervention study group and control group scores improved,and the study group were significantly lower than control group(P<0.05);intervention effect,significantly better than the intervention study group of patients with psychological system of patients in the control group(P<0.05). Conclusion:Recurrent abortion and chromosome distribution of couples are closely related,if at least one abnormal,timely prenatal diagnosis is necessary,and then take appropriate intervention measures to reduce the incidence of depression in patients with psychological intervention,improve the clinical effect,which can achieve satisfactory clinical outcome of pregnancy,should be further popularized.
Objective:To investigate the relationship between recurrent spontaneous abortion and chromosome karyotype distribution and the intervention measures. Methods:90 patients with recurrent spontaneous abortion from January 2016-2017 year in December in our hospital outpatient treatment of patients,were randomly divided into study group(n=45)and control group(n=45),the two groups of patients with chromosome distribution were observed,the control group were treated with conventional methods of intervention,application system research group on the basis of psychological intervention in patients the control group on measures. The changes of the self rating Depression Scale(SDS),self rating Anxiety Scale(SAS)and the effect of intervention between the two groups before and after intervention were observed,and the relationship between the effect of intervention and the distribution of chromosomal karyotype were observed. Results:The results of karyotype distribution of patients with recurrent spontaneous abortion patients with chromosome translocation and inversion,Turner′s syndrome(Turner),and Y Robertsonian translocation,Y has a close relationship(P<0.05);SDS,SAS score before the intervention,two groups of patients with SDS and SAS score significant differences(P>0.05),intervention study group and control group scores improved,and the study group were significantly lower than control group(P<0.05);intervention effect,significantly better than the intervention study group of patients with psychological system of patients in the control group(P<0.05). Conclusion:Recurrent abortion and chromosome distribution of couples are closely related,if at least one abnormal,timely prenatal diagnosis is necessary,and then take appropriate intervention measures to reduce the incidence of depression in patients with psychological intervention,improve the clinical effect,which can achieve satisfactory clinical outcome of pregnancy,should be further popularized.
引文
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[12]徐伯静,赵志梅,李雪娇,等.补肾调冲联合心理干预治疗复发性流产[J].现代中西医结合杂志,2016,11(7):1007-1010.
[13]Cao Y L,Zhang Z F,Wang J,et al.Association between polymorphisms of prokineticin receptor(PKR1 rs4627609 and PKR2 rs6053283)and recurrent pregnancy loss[J].J Zhejiang Univ Sci B,2016,17(3):218-224.
[14]金保方.复发性流产的男方因素与对策[J].中华男科学杂志,2017,23(10):867-872.
[15]欧阳芳芳,刘洁,孙玉春,等.不明原因复发性流产的三种治疗方法疗效对比分析[J].检验医学,2016,2(b11):37-39.
[2]陆宏,焦海燕,党洁,等.复发性自然流产与染色体核型关系的分析[J].宁夏医科大学学报,2016,38(2):151-153.
[3]谢华秀.染色体多态性与复发性流产的关系探讨[J].中国优生与遗传杂志,2017,2(2):58-59.
[4]Chung WH,Pan RY,Chu MT,et al.Oxypurinol-Specific T Cells Possess Preferential TCR Clonotypes and Express Granulysin in Allopurinol-Induced Severe Cutaneous Adverse Reactions.[J].Journal of Investigative Dermatology,2016,135(9):2237-2240.
[5]熊文栋,王连云,易宝珠.染色体多态性与女性不良孕产关系探讨[J].中国卫生检验杂志,2016,4(14):2053-2054.
[6]李亚丽,余小平,王方娜,等.复发性流产患者流产组织物的遗传学分析[J].中国妇幼保健,2016,31(3):536-538.
[7]贾新转,魏雅楠,魏兰,等.不明原因复发性流产患者生化妊娠史与妊娠结局关系的研究[J].福建医科大学学报,2017,51(5):323-325.
[8]朱航,朱红芬,齐涵沁.复发性流产女性的性激素与染色体核型分析[J].中国优生与遗传杂志,2017,5(1):48-49.
[9]Dai F,Wang R,Mengsi H U,et al.Relationship between HLAantibodies produceand the number of gravidity[J].Chinese Journal of Blood Transfusion,2017,1(7):207-210.
[10]陈兰婷,李大金,王凌.复发性流产的遗传学相关因素研究进展[J].生殖医学杂志,2017,3(11):1158-1162.
[11]钟韵,偶建,李红.胎儿染色体检查在复发性流产患者中的应用价值[J].国际生殖健康/计划生育杂志,2017,36(1):61-65.
[12]徐伯静,赵志梅,李雪娇,等.补肾调冲联合心理干预治疗复发性流产[J].现代中西医结合杂志,2016,11(7):1007-1010.
[13]Cao Y L,Zhang Z F,Wang J,et al.Association between polymorphisms of prokineticin receptor(PKR1 rs4627609 and PKR2 rs6053283)and recurrent pregnancy loss[J].J Zhejiang Univ Sci B,2016,17(3):218-224.
[14]金保方.复发性流产的男方因素与对策[J].中华男科学杂志,2017,23(10):867-872.
[15]欧阳芳芳,刘洁,孙玉春,等.不明原因复发性流产的三种治疗方法疗效对比分析[J].检验医学,2016,2(b11):37-39.