【摘要】 目的:探讨药物流产持续出血时子宫刮出物中胎盘催乳素(hPL)、胎盘特异性糖蛋白(PSβ1G)、胎盘碱性磷酸酶(PALP)和因子Ⅷ相关抗原的分布。方法:运用组织病理学和免疫组织化学方法,对正常药物流产排出组织(正常组:10例)和流产后持续出血而刮宫的刮出组织(出血组:20例)进行了研究。结果:(1)组织病理学:出血组中,刮出物包括子宫内膜、残留蜕膜、残留绒毛和绒毛外滋养层细胞。子宫内膜的腺体和基质发育不同步,有大量白细胞浸润。(2)免疫细胞化学:1)hPL和PSβ1G:正常组中,大部分蜕膜细胞为阴性,其中可见少量阳性的绒毛外滋养层细胞;绒毛的滋养层呈阳性。出血组中,子宫内膜和残留蜕膜也为阴性,某些蜕膜中弥散着大量阳性的绒毛外滋养层细胞;残留绒毛的滋养层为弱阳性。2)PALP和因子Ⅷ相关抗原显示血管功能:两组中,蜕膜中毛细血管内皮细胞和腺体上皮细胞都呈阳性;绒毛的滋养层细胞也呈阳性。结论:出血组的残留蜕膜中血液供应较好,绒毛外滋养层细胞所分泌hPL和PSβ1G能营养蜕膜,这些因素会导致蜕膜残留;而蜕膜残留、子宫内膜不同步发育和白细胞浸润最终导致药物流产后出血。更多还原

【Abstract】 Objective: To investigate the expression of human placental lactogen (hPL), placental specific glycoprotein (PSβ1G) .placental alkalase (PALP) and factor VIII related antigen in abstracted tissue after mifepristone induced abortion. Methods;Tissue were obtained from patients who underwent either mifepristone induced abortion (normal group, n = 10) or abstraction due to persistent bleeding (bleeding group, n =20). Histopathological and immunocytocheniical methods were used. Results: (1)Histopatholgy: In the bleeding group,the abstracted tissue contained endometrium,decidue,chorion villi and extravillous trophoblasts. In the endometrium there were lots of white blood cells. Endometrial glands and extracellular matrix were not synchronized. (2)Immunocytochemistry:hPL and PSB1G: In normal group, decidual cells were negative and extravillous trophoblasts showed positive. Trophoblasts were positive. In bleeding group, decidual cells and endometrium were negative. Extravillous trophoblasts increased and showed positive. Trophoblasts were weak positive. PALP and factor VIII related antigen: In both groups, decidual vascular endothelium,glandular epithelium and trophoblasts were positive. Conclusion: In bleeding group,normal blood circulation and extravillous trophoblasts’ nrtritional effects may cause decidue to grow. The growing decidue.endometrial inflammation and developmental differences may cause bleeding after mifepristone induced abortion.更多还原