PROBLEM:Thrombophilia has been associated with poor obstetrical outcomes. To determine the association of specific inherited thrombophilias and recurrent pregnancy loss, 10 thrombophilic genes were investigated. METHOD OF STUDY:A total of 550 women with a history of recurrent pregnancy loss had buccal swabs taken for DNA analyses of the following gene mutations: factor V G1691A, factor V H1299R (R2), factor V Y1702C, factor II prothrombin G20210A, factor XIII V34L, beta-fibrinogen -455G>A, PAI-1 4G/5G, HPA1 a/b(L33P), methylenetetrahydrofolate reductase (MTHFR) C677T, MTHFR A1298C. The frequencies of these mutations were compared with controls published in the literature. RESULTS:When examined individually, PAI-1 4G/5G (P = 0.009), factor XIII V34L (P < 0.0001), and homozygous MTHFR C667T (P < 0.0001) correlated significantly with recurrent pregnancy loss compared with controls. The frequency of the factor V Y1702C mutation was extremely low in patients and controls; thus, this gene was removed from further calculations. The remaining six mutated genes, when analyzed cumulatively, also corresponded with recurrent pregnancy loss (P < 0.0001). CONCLUSION:A panel of thrombogenic gene mutations consisting of factor V G1691A, factor V H1299R (R2), factor II prothrombin G20210A, factor XIII V34L, beta-fibrinogen -455G>A, PAI-1 4G/5G, HPA1 a/b(L33P), MTHFR C677T, and MTHFR A1298C can identify individuals at risk for recurrent pregnancy loss.

译文

问题:血友病与产科预后不良有关。为了确定特定遗传性血栓形成症与复发性流产的关联,研究了10个血栓形成性基因。
研究方法:总共550名有反复性流产史的妇女接受了口腔拭子以进行以下基因突变的DNA分析:因子V G1691A,因子V H1299R(R2),因子V Y1702C,因子II凝血酶原G20210A,因子XIII V34L,β-纤维蛋白原-455G> A,PAI-1 4G / 5G,HPA1a / b(L33P),亚甲基四氢叶酸还原酶(MTHFR)C677T,MTHFR A1298C。将这些突变的频率与文献中发表的对照进行了比较。
结果:当单独检查时,与对照组相比,PAI-1 4G / 5G(P = 0.009),XIII因子V34L(P <0.0001)和纯合MTHFR C667T(P <0.0001)与复发性流产显着相关。在患者和对照组中,V Y1702C因子突变的频率非常低。因此,该基因已从进一步的计算中删除。当进行累积分析时,剩下的六个突变基因也与复发性流产相对应(P <0.0001)。
结论:一组血栓形成基因突变,由因子V G1691A,因子V H1299R(R2),因子II凝血酶原G20210A,因子XIII V34L,β-纤维蛋白原-455G> A,PAI-1 4G / 5G,HPA1 a / b( L33P),MTHFR C677T和MTHFR A1298C可以识别有复发性流产风险的个体。

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