目的 改良早期自然流产胚胎绒毛膜细胞染色体的制备方法,并探讨其核型分析在自然流产病因诊断及下次妊娠指导中的临床作用.方法 于清宫手术时,无菌采集39例早期自然流产胚胎的绒毛；改进消化、低渗、固定等原位法制备绒毛细胞染色体的关键步骤；G显带法进行核型分析.结果 39例流产绒毛标本中,培养成功38例(97.4％),其中检出异常核型26例(68.4％),与正常核型比较,差异有统计学显著性意义(P＜0.01).26例异常染色体核型分布及其构成结果显示,核型异常以数目异常为主,与结构异常组比较,差异具有统计学显著性意义(P＜0.01).结论 胚胎染色体异常是早期自然流产最常见的原因,主要表现为数目异常.改良的绒毛细胞培养法和原位制备法具有成功率高、操作简便、耗时短及有利于准确进行核型分析的优点；对流产原因的查明,以及合理指导下次妊娠具有重要的临床意义.%Objective To make an improvement in karyotype preparation of aborted chorionic villus,and investigate the application of karyotype analysis for finding causes of spontaneous abortion and guiding the next pregnancy. Methods 39 cases of abortion chorionic villi were obtained by dilatation and curettage in the condition of sterilization. The chromosome specimens were prepared by modified methods on digestion,hypotonicity and fixation. Karyotype analysis on the cells was performed by G-banding technique. Results Successful karyotype analysis was performed in 38 of the 39 cases. The successful rate of the improved method was 97. 4%. In the 38 successful cases,chromosomal abnormalities were found in 26 of 38 cases (68. 4%) , being significantly different to absolutely normal ones (P<0. 01). The distribution of detailed abnormalities of the 26 cases showed that the abnormal karyotypes in number were more prevalent than those in structure (P<0. 01). Conclusion Embryonic chromosomal abnormality,especially abnormality in number is the most common cause of early spontaneous abortion. The improved method is better for the abortion chorionic villus preparation. It is highly successful,easy to operate,time saving and convenient for karyotype analysis, etc. Karyotype analysis of aborted villi is beneficial to identify the early spontaneous abortion reasons and help with guiding the next pregnancy.
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