米非司酮抗早孕时蜕膜纤溶酶原激活剂及其抑制物mRNA和蛋白表达研究  

Studies on Tissue - Type Flasminogen Activator and Flasminogen Activator Inhibitor Type -1 mRNA and Their Protein Expression Levels in Human Decidua after Terminating Early Pregnancy by Mifepristone plus Misoprostol.

作　　者：黄丽丽[1] 石一复[1] 

机构地区：[1]浙江大学医学院附属妇产科医院,杭州310006

出　　处：《中国计划生育学杂志》2002年第10期598-601,共4页Chinese Journal of Family Planning

摘　　要：目的:研究米非司酮配伍米索前列醇药物流产后蜕膜纤溶酶原激活剂及其抑制物(PA、PAI)变化,探讨药物流产后异常子宫出血的机理。方法:45例早孕受试者随机分成3组:正常蜕膜组、米非司酮组和米非司酮配伍米索前列醇药物流产组。应用逆转录—聚合酶链反应(RT-PCR)技术、发色底物法和酶联免疫吸附试验(ELISA)法观察3组蜕膜组织型纤溶酶原激活剂(tPA)和Ⅰ型纤溶酶原激活剂抑制物(PAI-1)mRNA及蛋白表达水平。结果:米非司酮米索组和米非司酮组tPA活性分别为46.91±20.74 IU/mg protein和64.25±35.81 IU/mg protein,低于正常蜕膜组(P<0.05);tPAmRNA水平以米非司酮米索组最高(1.43 0.39,P<0.05),而另两组间无差异(P>0.05);PAI-lmRNA和蛋白水平3组间均无差异(P>0.05)。结论:米非司酮和米索前列醇经转录后途径降低人早孕子宫蜕膜tPA活性,可能影响蜕膜剥落、血管再生、内膜复修而致药物流产后子宫出血时间过长。Objective:To investigate mifepristone plus misoprostol action on decidua at the levels of tPA and PAI -1 mRNA and protein expression,and the mechanism of prolonged uterine hemorrhage after terminating early pregancy by these drugs. Methods;45 decidua specimens were obtained from 45 pregnancy women with amenorrhea of 6-7 weeks'duration, in which 30 women were respectively treated with mifepristone or given mifepristone plus misoprostol. The tPA and PAI -1 mRNA levels were estimated by reverse transcription - polymerase chain reaction (RT - PCR). Chromogenic assay and enzmye - linked immunosorbant assay (ELISA) were used to detect tPA activity and PAI -1 protein level in decidua. Results : The tPA activities in mifepristone plus misoprostol group and mifepristone group were 46. 91±20.74 IU/mg protein and 64. 25±35. 81 IU/mg protein respectively .which lower than that in normal decidua group (99.76 ±58.61 IU/mg protein P <0.05). But tPA mRNA levels in mifepristone plus misoprostol group was the highest (1.43±0.39). In mifepristone group tPA mRNA level(0.90±0.16) had no significant difference compared with normal decidua group (0. 94±0. 17) . The protein and mRNA expression levels of PAI - 1 had no significant difference among 3 groups (P > 0.05). Conclusions: Mifepristone plus misoprostol decreased the tPA activity in human early decidua by post - transcription pathways,which may influence decidua shed.endometrial angiogenesis and remodel,and cause prolonged uterine hemorrhage after drug abortion.

关 键 词：米非司酮 抗早孕 蜕膜纤溶酶原激活剂 抑制物mRNA 蛋白表达 

分 类 号：R169.42[医药卫生—公共卫生与预防医学]