米非司酮对人早孕绒毛妊娠相关因子的影响  

The influence of mifepristone on the pregnancy related factors of the villus in early pregnancy

作　　者：王建升[1,2] 刘德瑜[2] 顾艳[3] 吴燕婉[2] 贾孟春[2] 

机构地区：[1]北京协和医学院研究生院,北京100730 [2]国家人口计生委科学技术研究所,北京100081 [3]天津医科大学第二附属医院,天津300211

出　　处：《生殖医学杂志》2009年第3期245-249,共5页Journal of Reproductive Medicine

基　　金：国家科技支撑计划课题(编号2006BAI03B10)

摘　　要：目的研究米非司酮对早孕绒毛妊娠相关因子的影响,探讨米非司酮抗早孕机理。方法将20名要求人工流产的正常妇女随机分为两组,其中10名妇女给予米非司酮150 mg,服药后12～24 h行负压吸宫术(研究组),10名妇女直接行负压吸宫术(对照组)。采用荧光实时定量聚合酶链反应(RT-PCR)方法检测两组绒毛组织中雌激素受体(ER)和孕激素受体(PR)的基因表达;采用免疫组织化学法检测两组早孕绒毛组织的骨桥蛋白(OPN),基质金属蛋白酶(MMP)-2和MMP-9的表达。结果研究组绒毛PR mRNA的表达显著高于对照组(P<0.01);两组绒毛ER mRNA的表达差异无统计学意义(P>0.05);研究组妇女早孕绒毛组织中OPN,MMP-2和MMP-9的表达显著低于对照组。结论米非司酮可使人早孕绒毛组织中PRmRNA的表达显著上调,改变人早孕绒毛组织中ER/PR的生理平衡,并且使OPN及MMP-2、-9的表达显著降低,这可能是其抗早孕终止妊娠机理之一。Objective：To explore the influence of mifepristone on the pregnancy related factors of the villus in early pregnancy. Methods： Twenty normal women requesting abortion were randomized to study and control groups. Ten Women in the study group took 150 mg of mifepristone 12- 24 h before vacuum aspiration. Ten women in the control group were performed directly vacuum aspiration. Real-time quantitative PCR （RT- PCR） was used to detect the gene expression of estrogen receptor （ER） and progesterone receptor（PR） in the villi from the women of both groups. Meanwhile the expressions of osteopontin （OPN）, matrix metal- loproteinase （MMP）-2 and MMP-9 in the villi were detected with immunohistochemistry method. Results： The expression of PR mRNA in the villi in the study group was significantly higher than that in the control group（P〈0.01）. There was no statistical difference of the expression of ER mRNA in the villi between the two groups（P〉0.05）. Compared with the control group, the levels of immunopositive stain of OPN, MMP-2 and MMP-9 in the villi following RU486 treatment significantly decreased. Conclusions： Mifepristone up-regulated the mRNA expression of PR and disturbed the balance of ER/ PR. Mifepristone significantly decreased the expressions of OPN, MMP-2 and MMP-9 in human villi as well. It might be the mechanism of termination of early pregnancy by mifepristone.

关 键 词：米非司酮 骨桥蛋白 基质金属蛋白酶 绒毛 

分 类 号：R979.22[医药卫生—药品] R169.42[医药卫生—药学]