阴道超声辐照对早孕胚胎绒毛细胞凋亡的影响  

The effect of transvaginal ultrasonography on the apoptosis of chorionic villi in the first-trimester pregnancy

作　　者：郝翠芳[1] 曲庆兰[1] 张宁[1] 包洪初[1] 王雄[1] 王梅梅[1] 庄丽丽[1] 

机构地区：[1]烟台毓璜顶医院生殖医学中心,山东264000

出　　处：《中国生育健康杂志》2008年第6期347-350,F0003,共5页Chinese Journal of Reproductive Health

摘　　要：目的探讨不同时间阴道超声辐照,对人早孕胚胎绒毛细胞凋亡的影响,以期为临床阴道超声辐照时限提供新的佐证。方法选择拟行人工流产的60例健康早孕妇女,分为对照组(未照射)、辐照3、5、10min组。应用探头频率5.0-MHz的阴道超声,对孕囊进行不同时间持续辐照。辐照后24h行人工流产取绒毛。采用末端脱氧核苷酸转移酶介导的原位末端标记法(TUNEL)行细胞凋亡的组织学检测,免疫组织化学方法(S-P法)检测促/抑凋亡基因Bax和Bcl-2蛋白在组织中的表达。结果对照组早孕绒毛细胞有少量凋亡细胞存在,辐照组凋亡细胞数目增加;辐照3min组出现凋亡细胞数目增多,与对照组比较,差异无统计学意义(P>0.05);随着照射时间延长凋亡细胞数目明显增加,辐照5min和辐照10min组与对照组及辐照3min组比较,差异有统计学意义(P<0.01)。对照组早孕绒毛中促凋亡Bax蛋白少量分布于合体滋养细胞胞浆中,细胞滋养细胞及间质含量极少,辐照组细胞滋养细胞及合体滋养细胞Bax蛋白含量均增加,但辐照3min及辐照5min组与对照组比较Bax蛋白表达,差异无统计学意义(P>0.05),辐照10min组Bax蛋白表达明显增强,与其它3组比较,差异有统计学意义(P<0.01)。抑制凋亡Bcl-2蛋白表达在各组间比较,差异无统计学意义(P>0.05)。结论阴道超声辐照后增加早孕绒毛细胞的凋亡,且随辐照时间的延长,绒毛细胞的凋亡指数逐渐升高,以辐照10min组的绒毛细胞凋亡指数最高。阴道超声辐照后早孕胚胎绒毛细胞滋养细胞及合体滋养细胞Bax蛋白表达增加,随着辐照时间的延长Bax蛋白表达逐渐增加;Bcl-2蛋白表达减弱,与阴道超声辐照时间长短无关。孕早期的阴道超声辐照3min内是安全的,辐照5min相对安全,阴道超声的直接辐照最好不要超过10min。Objective To investigate the effect of transvaginal ultrasonography （TVU） on the apoptosis of chorionic villi cells in first - trimester pregnancy. Methods 60 healthy women in first - trimester pregnancy were randomly divided into 4 groups according to different exposure time ： control group （ no radiation）, 3 min, 5 rain and 10 min radiation groups. Gestation sacs were radiated by TVU with 5. 0-MHz transducer. The chorionic villi were collected 24 hours after exposure. The apoptosis of chorionic villi cells were analyzed by TUNEL. The expression of Bax and Bcl-2 proteins were analyzed by immunohistochemistry. Results The apoptosis cells of chorionic villi were increased according to the time of exposure. In contrast with the control group and 3 rain group, the apoptosis cells were increased significantly in 5 min and 10 min groups （P 〈0. 01 ）. There was no difference between control group and 3 min group （P 〉 0. 05 ）. The expression of the Bax in syncytiotrophoblast and cytotrophoblasts were increased significantly in 10 min group （P 〈 0. 01 ） compared with other groups. The expression of Bcl-2 decreased in 3rain, 5min and 10rain groups in contrast with control group, but there were no difference between the four groups （ P 〉 0.05 ）. Condusions The apoptosis of chorionic villi cells increased after the exposure to TVU, and the apoptosis index increased according to the time of exposure. The apoptosis index was highest in the 10rain group, but there was no difference between control group and 3 min group. The expression of Bax protein in the cytotrophoblasts and syncytiotrophoblasts increased after the exposure to TVU, and varied accoding to the exposure time. The expression of Bcl-2 protein in the cytotrophoblasts decreased after the exposure to TVU, which was independent on the exposure time. In the early pregnancy stage, it is safe to expose the fetus to TUV within 3 minutes. And it is almost safe within 5 minutes. But the time expose to TUV should not longer than 10 minutes.

关 键 词：阴道超声 胚胎 绒毛 凋亡 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.8[医药卫生—诊断学]