高原胎盘的病理形态学研究

Pathomorphology of Placenta at High Altitude

目的：研究高原胎盘的组织形态及超微结构变化，探讨形态变化对孕妇和胎儿的影响。方法：对３２００ｍ以上原高胎盘２６例与１３００ｍ以下的喀什及西安地区胎盘５０例进行比较观察。结果：①高原新生儿体重均数绝对值２９１５．３８ｇ，较对照组少３７４．４２ｇ（Ｐ＜０．０１）；②高原胎盘重量均数绝对值４８５．１２ｇ，明显低于对照组５８３．６８ｇ（Ｐ＜０．０１）；③组织学检查：具有合体细胞结节、血管合体膜、血管增多、朗罕氏细胞、绒毛纤维素样坏死等绒毛均高于对照组（Ｐ＜０．０１）；④超微结构观察：高原胎盘绒毛的合体细胞及朗罕氏细胞增生明显，粗面内质网高度扩张，滋养叶基底膜明显增厚，可达正常的几倍至十几倍。结论：高原缺氧能引起高原妊娠胎盘组织形态及结构改变，致使婴儿体重减轻。

Purpose: To study pathomorphology and ultrastructure of placenta at high altitude and to explore the effect of morphologic changes on pregnant women and fetuses. Methods: Comparative observation was taken in 26 placentas at regions more than 3 000 m altitudes and 50 cases at regions less than 1 300 m altitudes. Results: (1) The mean value of newborn weight(2915.38 g) in high altitude group was 374.42 g lower than that in control group( P <0.01).(2)The mean value of placenta weight(485.12 g) in high altitude group was obviously lower than that (583.68 g) in control group ( P <0.01). (3) Histologic examination showed that the numbers of villi with syncytial cell node, vascular syncytial membrane and hyperplasia, Langerhans′ cells, villus fibrinoid necrosis in high altitude group were all higher than those in control group ( P <0.01). (4) Ultrastructural observation in high altitude group showed significant hyperplasia of syncytial cells and Langerhans′ cells in placenta villi, high expansion of rough surfaced endoplasmic reticulum and very thick trophoblastic basement membrane. Conclusion: Oxygen deficit in high altitude regions can cause histologic and structural changes of placenta in pregnant phase, which may induce the fetus weight lighter.