米非司酮对人早孕不同时期绒毛组织病理结构及survivin、caspase-3表达的影响  

Effects of mifepristone on structure and expressions of Survivin and caspase-3 in villi in women with different gestational ages

作　　者：侯自红[1] 何双[1] 顾向应[1] 张爱娟[1] 岳秀英[2] 

机构地区：[1]天津医科大学总医院计划生育科,300052 [2]天津市宝坻区人民医院

出　　处：《中国计划生育学杂志》2013年第9期580-584,590,共6页Chinese Journal of Family Planning

摘　　要：目的：观察米非司酮对早期妊娠妇女绒毛组织病理结构改变及对凋亡抑制基因survivin和半胱氨酸蛋白酶家族成员caspase-3表达的影响,探讨米非司酮抗早孕作用的机制.方法：选取2011年5月1日～2011年6月30日在天津医科大学总医院计划生育门诊自愿要求终止早孕的妇女60例,其中妊娠40 ～ 49d 30例,随机分对照A组和观察A组,每组各15例；妊娠50 ～ 63d 30例,随机分对照B组和观察B组,每组各15例.两对照组常规行负压吸宫术终止妊娠,两观察组在行负压吸宫术前48h开始服用米非司酮50mg,间隔12h后服25mg,连服2d,总计150mg.收集4组绒毛组织,常规HE染色后镜下观察绒毛组织细胞增生结节数及免疫组织化学法检测survivin及caspase-3的表达情况.结果：①对照组绒毛细胞增生结节数高于观察组（P＜0.05）,对照A组与对照B组比较,观察A组与观察B组比较,绒毛滋养细胞增生结节数无统计学差异（P均＞0.05）.②对照组与观察组绒毛组织中滋养层细胞胞浆和胞核survivin均表达阳性,但观察组表达强度低于对照组（P＜0.05）.对照A组与对照B组比较,观察A组与观察B组比较,survivin的表达强度无统计学差异（P均＞0.05）.③对照组与观察组绒毛组织滋养层细胞胞浆中caspase-3均表达阳性,但对照组表达强度低于观察组（P＜0.05）,观察A组与B组表达无统计学差异（P＞0.05）.结论：米非司酮抑制绒毛组织滋养层细胞增生结节的形成,抑制survivin的表达,促进caspase-3的表达,使细胞促凋亡系统占优势,胎囊组织无法存活,从而实现抗早孕的目的.150mg米非司酮用于终止50 ～ 63d早孕与终止≤49d早孕效果相近.Objective：To explore the pathological change and expressions of Survivin and caspase-3 in villi in women with different gestational ages.Methods：Sixty specimens were collected from women seeking for termination of early pregnancy in Department of Gynecology and Obstetrics of The General Hospital of Tianjin Medical University between May 1,2011 and June 30,2011.Thirty women with 40 to 49 days of gestational ages were randomly divided into two groups （control group A and study group A）,and the other 30 women with 50 to 63 days of gestational ages were randomly divided into two groups （control group B and study group B）.Women in the study group were treated with 150 microgram mifepristone before artificial abortion with suction evacuation.The villus tissue was collected.The pathological change of villus was evaluated with a light microscope and expression levels of Survivin and caspase-3 in villi were detected by immunohistochemistry technique.Results：In study groups,proliferation nodules of trophoblastic cells were significantly reduced （P ＜ 0.05）.There were no significant differences in the number of proliferation nodules of trophoblastic cells between control A and B groups as well as study A and B groups （P both ＞ 0.05）.Expressions of Survivin were observed in the nucleus and cytoplasm of the villi in the control group and the study group.The expression level of Survivin was lower in the study group （P ＜ 0.05）.There were no significant differences in expression level of Survivin between control A and B groups as well as study A and B groups （P both ＞0.05）.Expressions of caspase-3 were observed in the cytoplasm of the villi in the control group and the study group.The expression level of caspase-3 was lower in the control group （P ＜ 0.05）.There were no significant differences in expression level of caspase-3 between control A and B groups as well as study A and B groups （P both ＞ 0.05）.Conclusion：Mifepristone could inhibit the formation of proliferation nodules

关 键 词：米非司酮 绒毛 增生结节 免疫组化 SURVIVIN caspase-3 早孕 

分 类 号：R714.21[医药卫生—妇产科学]