不同超声辐照联合超声造影剂对人孕早期绒毛组织的损伤作用  

Early Human Chorionic Villi Damage Caused by Different Ultrasonic Irradiation Combined with Ultrasound Contrast Agent

作　　者：张婷[1] 刘志跃[2] 杨敬英[1] 王金锐[1] 李汇文[1] 徐霞[1] 

机构地区：[1]鄂尔多斯市中心医院超声科,内蒙古鄂尔多斯017000 [2]内蒙古医学院基础医学院病理生理学教研室,内蒙古呼和浩特010059

出　　处：《中国医学影像学杂志》2012年第6期437-440,444,共5页Chinese Journal of Medical Imaging

摘　　要：目的探讨不同超声辐照联合超声造影剂对人孕早期绒毛组织超微结构及凋亡的影响。资料与方法选择人工流产的36例患者,按就诊顺序随机分为对照组、低机械指数(MI≤0.15)造影组、高机械指数(MI=1.0)造影组(击破再灌注)。其中低机械指数造影组进一步分为MI=0.07、0.09、0.13、0.154个亚组。造影后24h内行人工流产取出绒毛组织,透射电镜观察绒毛的超微结构,免疫组化检测Bcl-2蛋白表达。结果电镜观察显示:高机械指数造影组与对照组及低机械指数造影组比较,绒毛组织损伤程度更明显;而各低机械指数造影组及对照组绒毛组织破坏不明显。免疫组化结果显示:高机械指数造影组绒毛合体滋养层细胞Bcl-2蛋白表达较对照组及各低机械指数造影组明显减少(P<0.05);各低机械指数造影组与对照组Bcl-2表达变化不明显(P>0.05)。结论高机械指数超声辐照联合超声造影剂对人早孕胚胎组织有明显损伤作用,而低机械指数超声造影在产科应用中较安全。Purpose To explore the influence of ultrasonic irradiation combined with ultrasound contrast agents on the ultrastructure of human first trimester chorionic villi and apoptosis.Materials and Methods Thirty-six women requesting voluntary abortion were chosen and randomly assigned into control group,low mechanical index （MI） contrast group （MI≤0.15） and high mechanical index contrast group （MI=1.0）.The low mechanical index group was divided into MI=0.07,0.09,0.13 and 0.15 subgroups.After ultrasound studies,the chorionic villi tissue was taken out after induced-abortion in 24 hours.The ultrastructure of chorionic villi was observed on transmission electron microscopy.The expression of apoptosis-related gene Bcl-2 protein was detected using immunohistochemical staining method.Results Electron microscopy results showed more villi damage in high mechanical index group than in control and low mechanical index groups.There was no difference in villi damage between low mechanical index and control groups.Immunohistochemical results showed significant decrease of Bcl-2 protein expression in syncytiotrophoblast cells in high mechanical index contrast group （P〈 0.05） compared with the control group and the low mechanical index contrast groups,Bcl-2 expression was not significantly different between control and low MI groups （P〉 0.05）.Conclusion High mechanical index ultrasound irradiation combined with ultrasound contrast agent causes human embryo injury.Low mechanical index ultrasonography is safer in obstetric applications.

关 键 词：妊娠初期 绒毛膜绒毛 超声检查 产前 造影剂 超微结构 基因 BCL-2 

分 类 号：R714.1[医药卫生—妇产科学] R445.1[医药卫生—临床医学]