妊娠高血压综合征合并胎儿宫内发育迟缓胎盘病理改变  

The Placenta Pathological Change of Pregnancies Induced Hypertension Complicated with Intrauterine Growth Retardation

作　　者：王志坚[1] 余艳红[2] 

机构地区：[1]解放军202医院,辽宁沈阳110003 [2]第一军医大学南方医院,广东广州510516

出　　处：《实用妇产科杂志》2002年第5期288-289,共2页Journal of Practical Obstetrics and Gynecology

基　　金：广东省社会重大问题联合攻关项目 (课题编号 :0 12 2 0 0 15 )

摘　　要：目的 :通过对妊娠高血压综合征 (妊高征 )合并胎儿宫内发育迟缓的胎盘光镜和电镜观察 ,了解妊高征合并IUGR的胎盘病理改变 ,从而探讨妊高征引起 IU GR的原因。方法 :选取妊高征合并 IU GR患者、正常妊娠妇女胎盘各 30例 ,常规 HE染色及 PAS染色 ,观察胎盘形态学变化。另取妊高征合并 IUGR及正常胎盘各 5例 ,5 0 0 H型透射电镜观察。结果 :观察组绒毛间质纤维化及纤维素样坏死 >3%、绒毛间质白细胞浸润、合体滋养细胞结节 >30 %、绒毛血管减少瘀血、细胞滋养细胞增生 >2 0 %、滋养细胞基底膜增厚 >3%的数量均明显高于对照组 ,电镜发现合体滋养细胞超微结构改变明显 ,蜕膜螺旋动脉内皮损伤 ,管腔狭窄 ,部分动脉末端闭塞。结论 :妊高征引起 IUGR的病理改变主要有三方面 :绒毛毛细血管减少、瘀血 ;血管合体膜增厚 ;蜕膜螺旋动脉狭窄、闭塞。这也是妊高征造成 IUObjectives:To study the pathological change in placenta of pregnancy induced hypertension complicated with intrauterine growth retardation by microscope and electron microscope and to discuss the pathogenesis of intrauterine growth retardation originated from PIH.Methods:The placental samples were collected separatively from 30 pregnancies with PIH complicated with IUGR patients and 30 normal pregnant women.The tissue sections were dealt with HE stainning and PAS stainning and then were observed by microscope to investigate the morphological change.Taking another 5 samples from each group and making an observation by 500H model electron microscope.Results:The count of stroma fibrosis and fibrinoid necrosis of villi>3%,stroma leucocyte soakage of villi,villous syncytial knots>30%,villous vascular decrease and gore,and cytotrophoblasts>20% and thicking of basal lamina>3% were more significant in the placenta of PIH with IUGR group than that of normal group.The Syncytiotrophoblast ultrastructure had markable changes,endodermis damnification of decidua spiral arteries,straitness of arteries cavity and partly obstruction of arteries extremity were found by electron microscope.Conclusions:The placented pathological change of IUGR induced by PIH are decrease and gore of villous capillary ,incrassation of vasculosyncytial membranes ,straitness and obstruction of decidua spiral arteries.Its also the pathological cause that PIH induces IUGR.

关 键 词：妊娠高血压综合征 胎儿宫内发育迟缓 胎盘 病理学 形态学 

分 类 号：R714.246[医药卫生—妇产科学] R714.431[医药卫生—临床医学]