上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

复发性自然流产1 101例病因分析

刘志兰，康晓敏，张晓欣，徐海静，王统菲，贺立颖，赵爱民   

  1. 上海交通大学 医学院附属仁济医院妇产科， 上海 200127
  • 出版日期:2015-03-28 发布日期:2015-03-26
  • 通讯作者: 赵爱民, 电子信箱: zamzkh0526@126.com。
  • 作者简介:刘志兰（1988—）， 女， 博士生; 电子信箱: liuzhilan0410@126.com。

Analysis of etiology of 1 101 cases of recurrent spontaneous abortion

LIU Zhi-lan, KANG Xiao-min, ZHANG Xiao-xin, XU Hai-jing, WANG Tong-fei, HE Li-ying, ZHAO Ai-min   

  1. Department of Obstetrics and Gynecology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
  • Online:2015-03-28 Published:2015-03-26

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摘要：

目的 分析复发性自然流产的病因，为临床诊断、治疗提供依据。方法 对2010年1月—2014年10月在上海交通大学医学院附属仁济医院妇科门诊就诊，确诊为复发性自然流产患者1 101例进行病因分析。结果 1 101例患者中，母体因素分析发现：单因素病因者有551例，占50.05%；多因素病因者有148例，占13.44%；另有402例原因不明，占36.51%。结论 复发性自然流产的病因复杂，包括母体因素如夫妻染色体异常、生殖道解剖异常、自身免疫因素、内分泌异常和血栓前状态等，胚胎因素如胚胎染色体异常以及母胎间妊娠免疫耐受失衡等多种因素。对复发性流产患者再次妊娠前进行全面系统而规范的病因筛查，并且针对病因进行个体化综合治疗，对于提高再次妊娠治疗的成功率有非常重要的意义。

关键词: 复发性, 自然流产, 病因分析, 单因素, 多因素

Abstract:

Objective To analyze the etiology of recurrent spontaneous abortion and provide evidences for clinical diagnosis and treatment. Methods Data of 1 101 patients who were diagnosed as recurrent spontaneous abortion from January 2010 to October 2014 at the outpatient clinic of Department of Gynecology of Renji Hospital, Shanghai Jiao Tong University School of medicine were collected and the etiology of recurrent spontaneous abortion was analyzed. Results Among 1101 cases, analysis of maternal factors showed that the recurrent spontaneous abortion of 551 cases (50.05%), 148 cases (13.44%), and 402 cases (36.51%) were single cause, multi-causes, and unknown causes, respectively. Conclusion The etiology of recurrent spontaneous abortion is complicated, including maternal factors such as marital chromosomal abnormalities, reproductive tract anatomical abnormalities, autoimmune factors, endocrine abnormalities, and prothrombotic status, and embryonic factors such as embryonic chromosomal abnormalities, immune tolerance between maternal-fetal pregnancy imbalance, etc. Comprehensive and regular screening of causes for patients with recurrent spontaneous abortion before pregnancy and individualized treatment according to causes are vital for improving the rate of successful pregnancy.

Key words: recurrent, spontaneous abortion, etiology analysis, single cause, multi-causes