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1、唐氏綜合征產(chǎn)前診斷研究進(jìn)展覃婷(綜述)施月秋(審校)作者單位:530021南寧廣西壯族自治區(qū)人民醫(yī)院產(chǎn)科作者簡(jiǎn)介:覃婷(1974—),女,大學(xué)本科,碩士學(xué)位,主治醫(yī)師,研究方向:婦產(chǎn)科。E-mail:gxqinting@yahoo.com.cn摘要:我國(guó)每年約有3萬(wàn)唐氏綜合征患兒出生,在各種出生缺陷中排第三位,是最常見(jiàn)的染色體異常。為了減少唐氏綜合征患兒的出生,近年絨毛,羊水,臍血介入性產(chǎn)前診斷廣泛開展,使部分唐氏綜合征得到產(chǎn)前診斷,并治療性引產(chǎn),減少了唐氏綜合征患兒的出生,但侵入性手術(shù)操作的風(fēng)險(xiǎn)和漫長(zhǎng)的等待結(jié)果的時(shí)間給孕婦造成了巨大的心理壓力。因此植
2、入前產(chǎn)前診斷,分離孕婦外周血中胎兒有核紅細(xì)胞,分離孕婦血漿中胎兒游離DNA,宮頸管內(nèi)滋養(yǎng)細(xì)胞等新技術(shù)正在展開研究,已經(jīng)成功地?zé)o創(chuàng)性獲取胎兒細(xì)胞或DNA樣本。熒光定量PCR,熒光原位雜交技術(shù)(FISH),引物原位標(biāo)記技術(shù)(PRINS),微陣列一比較基因組雜交等分子生物學(xué)技術(shù)為快速,準(zhǔn)確診斷唐氏綜合征開辟了新前景。現(xiàn)就唐氏綜合征產(chǎn)前診斷基礎(chǔ)性研究及臨床應(yīng)用的進(jìn)展情況作一綜述。[關(guān)鍵詞]:唐氏綜合征產(chǎn)前診斷[中圖分類號(hào)]R596.1[文獻(xiàn)標(biāo)識(shí)碼]A[文章編號(hào)]1674-3806(2009)AreviewonPrenatalDiagnosisofDownSyn
3、dromeQINTing(Summarize),SHIYue-qiu(Revise).DepartmentofGynecology&ObstetricsofPeople'sHospitalofGuangxiZhuangAutonomousRegion,Nanning530021,China【Abstract】Everyyear,thereareabout30thousandbabiesbornwithDSinChina,whichranksthethirdamongallkindsofbirthdefects.Inordertoreducethebir
4、thof11babieswithDS,theinterventionalprenataldiagnoses,suchaschorionicvillussampling,amniocentesisandcordocentesis,havebeenwidelycarriedoutinrecentyears,whichhasreducedthebirthofbabieswithDS.However,theriskofinvasiveoperationandthelongperiodofwaitingwillcausetheheavymentalpressur
5、eofpregnantwomen.Therefore,thestudyonaseriesofnewtechniqueshasbeendeveloped,includingpreimplantationgeneticdiagnosis,isolationoffetalnucleatedredbloodcellsfrommaternalperipheralblood,isolationofcell-freefetalDNAinmaternalplasma,endocervicalfetaltrophoblast.ThefetalcellsorDNAsamp
6、leshavebeensuccessfullyobtainedwiththosenon-invasivemethods.Moreover,thetechniquesofmolecularbiologyhavebroughtnewprospectstotherapidandaccuratediagnosisofDS,includingfluorescencequantitativepolymerasechainreaction(PCR),fluorescenceinsituhybridization(FISH),primedinsitulabeling(
7、PRINS)andarraycomparativegenomichybridization(Array-CGH).Inthispaper,weaimtomakeasummaryontheprogressofthebasicresearchandclinicalapplicationofprenataldiagnosisforDS.【KeyWords】DownSyndrome;PrenatalDiagnosis唐氏綜合征是最常見(jiàn)的染色體異常。因患兒存活時(shí)間長(zhǎng),缺乏生活自理能力,對(duì)家庭、社會(huì)造成了沉重的負(fù)擔(dān)。現(xiàn)就唐氏綜合征產(chǎn)前診斷基礎(chǔ)性研究及臨床應(yīng)用的進(jìn)展
8、情況作一綜述。1唐氏綜合征產(chǎn)前診斷取材方法1.1絨毛活檢術(shù)(CVS)胎盤絨毛和胎兒均起源于受精