稽留流产绒毛组织中IGF-1、E-cadherin、微血管密度表达与药物治疗结果的相关性研究  

Study on the correlation between the expression of IGF-1,E-cadherin and microvessel density in the villi of missed abortion and drug treatment outcome

作　　者：刘竞 张兰[1] 曾利[1] 马丽[1] LIU Jing;ZHANG Lan;ZENG Li;MA Li(Department of Obstetrics,Bazhong Central Hospital,Sichuan Bazhong 636000,China)

机构地区：[1]巴中市中心医院产科,四川巴中636000

出　　处：《中国妇幼健康研究》2023年第2期74-79,共6页Chinese Journal of Woman and Child Health Research

基　　金：四川省基层卫生研究项目(SWFZ20-C-100)。

摘　　要：目的分析探讨稽留流产绒毛组织中胰岛素样生长因子-1(IGF-1)、E-钙黏附蛋白(E-cadherin)表达情况、微血管密度(MVD)与药物治疗结局的相关性。方法收集2019年9月至2021年8月在巴中市中心医院妇产科收治的进行药物治疗的稽留流产患者95例为研究组、正常早孕患者108例为对照组;所有患者均采用米非司酮配伍米索前列醇的统一药物方案进行治疗,采用免疫组织化学法检测绒毛组织中IGF-1、E-cadherin和MVD的表达,并分析药物治疗发生不完全流产的影响因素。结果研究组绒毛组织中IGF-1、E-cadherin的阳性表达率和MVD相对表达量均低于对照组(χ^(2)=4.67,P=0.03;χ^(2)=18.43,P<0.01;t=46.71,P<0.01);两组患者接受药物治疗后,不完全流产的发生率为18.72%;研究组不完全流产发生率(28.42%)高于对照组(10.19%),差异有统计学意义(χ^(2)=11.05,P<0.01);多因素Logistic回归分析结果显示,痛经(OR=2.24,95%CI:1.36~3.71,P<0.01)是药物治疗后发生不完全流产的独立危险因素;绒毛组织中E-cadherin的表达(OR=0.69,95%CI:0.55~0.70,P<0.01)和MVD的表达(OR=0.72,95%CI:0.68~0.78,P<0.01)均为患者接受药物治疗后发生不完全流产的独立保护因素。结论稽留流产患者绒毛组织中IGF-1、E-cadherin表达和MVD含量较低;接受药物治疗后不完全流产患者绒毛组织中E-cadherin、MVD相对较低。Objective To analyze the correlation between the expression of insulin-like growth factor-1(IGF-1),E-cadherin and microvessel density(MVD)in the villi of missed abortion and drug treatment outcome.Methods From September 2019 to August 2021,a total of 95 patients with missed abortion and treated in the Bazhong Central Hospital were collected as the research group,and 108 patients with normal early pregnancy were the control group.All patients were treated with a unified drug regimen of mifepristone and misoprostol.The expressions of IGF-1,E-cadherin and MVD in villus tissue were detected by immunohistochemistry,and the influencing factors of incomplete abortion were analyzed.Results The positive expression rates of IGF-1 and E-cadherin and the relative expression of MVD in the villi of the study group were lower than those of the control group(χ^(2)=4.67,P=0.03;χ^(2)=18.43,P<0.01;t=46.71,P<0.01).After receiving medical treatment,the incidence of incomplete abortion was 18.72%.The incidence of incomplete abortion in the study group(28.42%)was significantly higher than that in the control group(10.19%),and the difference was statistic significant(χ^(2)=11.05,P<0.01).Multivariate Logistic regression analysis showed that dysmenorrhea(OR=2.24,95%CI:1.36-3.71,P<0.01)was an independent risk factor for incomplete abortion after drug treatment.The expression of E-cadherin(OR=0.69,95%CI:0.55-0.70,P<0.01)and MVD(OR=0.72,95%CI:0.68-0.78,P<0.01)in villus tissue were the independent protective factors for incomplete abortion after drug treatment.Conclusion The expression levels of IGF-1,E-cadherin and MVD in chorionic villi of patients with missed abortion are lower.The expression levels of E-cadherin and MVD in villi of patients with incomplete abortion after drug treatment are lower.

关 键 词：胰岛素样生长因子-1 E-钙黏附蛋白 稽留流产 微血管密度 药物治疗 

分 类 号：R173[医药卫生—妇幼卫生保健]