非孕妇女口服米非司酮对宫颈软化作用的观察及其机制的探讨  

Observation on the effect of oral administration of mifepristone on cervical softening of non-pregnant women and exploration on the mechanism

作　　者：沈奕[1] 曹树军[1] 原玮[1] 祝亚平[2] 

机构地区：[1]上海交通大学附属第一人民医院松江分院妇产科,201600 [2]上海交通大学附属第一人民医院妇产科

出　　处：《中国妇幼保健》2011年第9期1306-1309,共4页Maternal and Child Health Care of China

摘　　要：目的:观察服用米非司酮后的非孕妇女宫颈扩张度的改变及MMP-9、MMP-2、TIMP-1在宫颈组织中的表达,探讨米非司酮是否具有促非孕妇女宫颈成熟的作用及其相关机制。方法:①把90例要求行诊断性刮宫的非孕妇女随机分为A1、B1、C1三组各30例,分别为对照组、服用米非司酮组及服用米索组;所有患者均用扩宫棒先进行非用力宫颈最大扩张度的测定,48 h后行诊断性刮宫术,并于手术前再次测定宫颈非用力最大扩张度,观察三组不用力宫颈最大扩张度的变化。②A1、B1、C1组诊刮术前取部分宫颈组织作为标本(共56例),分别作为B2、C2、D2组,同时取17例非诊刮行全子宫切除患者A2组的部分宫颈组织作阴性对照,显微镜下观察四组宫颈的形态学变化,采用免疫组化Elivison二步法检测宫颈组织的MMP-9、MMP-2及TIMP-I的表达。结果:①C2组用药前后宫颈扩张的差异与A2,B2组相比有统计学意义,与D2组相比差异没有统计学意义;②C2组和D2组镜下显示组织水肿疏松,间隙增宽,毛细血管扩张,毛细血管中及周围可见较多的中性粒细胞及浆细胞浸润,A2组未观察到此改变,B2组可见轻度组织水肿改变,炎性细胞浸润不明显;C2组宫颈组织中的MMP-9的表达明显高于A2组及B2组,而与D2组无明显差异;MMP-2、TIMP-1在四组中的表达差异均不明显。结论:米非司酮有促进非孕妇女宫颈成熟的作用,MMP-9参与了此过程,而此药对MMP-2及TIMP-1的表达没有影响,米非司酮能促宫颈成熟可能与它的抗孕作用相关。Objective：To observe the change of cervical dilatation degree of non-pregnant women after oral administration of mifepristone and the expression levels of MMP-9,MMP-2 and TIMP-1 in cervical tissues,explore the effect of mifepristone on cervical maturity of non-pregnant women and the related mechanism. Methods：90 non-pregnant women demanding diagnostic curettage were divided into A1 group（control group）,B1 group（mifepristone group） and C1 group（misoprostol group） randomly,30 women in each group;the largest cervical dilatation degrees of all the women were detected by cervical dilator,then diagnostic curettage was conducted after 48 hours,the largest cervical dilatation degrees were detected again before surgery,the changes of largest cervical dilatation degree in the three groups were observed;partial cervical tissue samples were obtained before diagnostic curettage in the three groups（56 samples）,then the samples were designed as B2 group,C2 group and D2 group;and partial cervical tissue samples were obtained from 17 women receiving total hysterectomy as negative control group,the morphological changes of cervical tissues in the four groups were observed under microscope,immunohistochemical method（Elivison） was used to detect the expression levels of MMP-9,MMP-2 and TIMP-1 in cervical tissues. Results：There was significant difference in changes of cervical dilatation degree between C2 group and A2 group,B2 group before and after treatment;but there was no significant difference between C2 group and D2 group before and after treatment;in C2 group and D2 group,edema was found under microscope,the intercellular space became larger,the capillary vessels dilated,many neutrophils and plasma cells infiltration were found in capillary vessels and the adjacent tissues;in A2 group,above-mentioned changes were not found,in B2 group,mild edema was found,the filtration of inflammatory cells was not obvious;the expression level of MMP-9 in C2 group was significantly higher than those in A2 group and B

关 键 词：非孕妇女宫颈基质金属蛋白酶组织金属蛋白酶抑制剂-1 

分 类 号：R737.33[医药卫生—肿瘤]