产后出血与羊水栓塞关系的初步研究  

Preliminary study on the relationship between postpartum hemorrhage and amniotic fluid embolism

作　　者：赵敏[1] 余舰[1] 张国栋[2] 

机构地区：[1]遵义医学院法医学系,贵州遵义563003 [2]遵义医学院

出　　处：《中国妇幼保健》2011年第3期356-357,共2页Maternal and Child Health Care of China

摘　　要：目的:检测羊水及胎粪的特征性成分—STN抗原在产后出血病例中的表达,查找引起产后出血的确切病因,初步探讨产后出血与羊水栓塞的关系。方法:通过HE染色、STN抗原免疫组化染色,对20例尸检标本进行回顾性研究。结果:临床诊断为产后出血的15例病例中,STN抗原表达阳性8例。HE染色均未观察到鳞状上皮、胎粪小体、胎脂及黏液等羊水有形成分。尸检及HE染色明确诊断为羊水栓塞的2例病例(阳性对照组),STN抗原表达均呈阳性,HE染色观察到胎脂或胎粪小体的存在。其他死因的3例病例(阴性对照组),STN抗原表达均呈阴性,HE染色没有观察到羊水有形成分。STN抗原的阳性率:实验组与阳性对照组、阴性对照组比较差异有统计学意义(P<0.05)。结论:原因不明的产后出血,可通过免疫组化方法检测羊水及胎粪的特征性成分—STN抗原,以判断是否为羊水进入母体血循环,导致不典型羊水栓塞的发生,从而明确引起产后出血的原因。Objective：To detect the expression of STN antigen which was the characteristic component of amniotic fluid and meconium in the cases with postpartum hemorrhage,find out the clear pathological causes of postpartum hemorrhage,explore the relationship between postpartum hemorrhage and amniotic fluid embolism preliminarily.Methods：20 autopsy specimens were analyzed retrospectively by HE staining and STN antigen immunohistochemical staining.Results：Among 15 cases diagnosed as postpartum hemorrhage,8 cases were found with positive STN antigen;tangible components in amniotic fluid including squamous epithelium,meconium body,fetal fat and mucus were not found by HE staining;2 cases were diagnosed as amniotic fluid embolism by autopsy and HE staining（positive control group）,and they were found with positive STN antigen,fetal fat and meconium body by HE staining;3 cases died because of other causes（negative control group）,and they were found with negative STN antigen,no tangible components in amniotic fluid was found by HE staining;there was significant difference in positive rate of STN antigen among experimental group,positive control group and negative control group（P〈0.05）.Conclusion：For the cases with unexplained postpartum hemorrhage,STN antigen which is the characteristic component of amniotic fluid can be detected by immunohistochemistry in order to determine if amniotic fluid enters into blood circulation of pregnant women and induce the occurrence of atypical amniotic fluid embolism,then the causes of postpartum hemorrhage can be made clear.

关 键 词：STN抗原 产后出血 羊水栓塞 免疫组织化学 

分 类 号：R714.461[医药卫生—妇产科学] R714.468[医药卫生—临床医学]