摘要
对 32例ICP及 12例正常胎盘组织进行了组织形态计量学测定 ,并分析了组织计量学参数与实验室淤胆指标 (血甘胆酸、GPT、T -BI、D -BI)、胎儿预后 (羊水粪染、胎儿宫内窘迫 )的关系。测定表明 :ICP组胎盘的实质体积百分比、绒毛间腔容积百分比小于对照组 ,合体结节占绒毛结构容积百分比大于对照组 ,其中以重症组差异为显著。相关回归分析表明 :合体结节占绒毛结构容积百分比、绒毛组织容积百分比、绒毛间腔容积百分比与血甘胆酸相关性显著 (r =0 .52 1,p <0 .0 1;r=0 .4 0 1,p <0 .0 5;r =- 0 .32 8,p <0 .0 5) ;绒毛间腔容积百分比与羊水粪染程度、胎儿宫内窘迫相关性显著 (r =- 0 .355,p <0 .0 5;r =- 0 .34 6,p <0 .0 5) ;血甘胆酸与羊水粪染程度相关性显著 (r=0 .4 0 2 ,p <0 .0 5)。结论 :ICP时最主要的胎盘组织形态学异常是绒毛间腔狭窄及合体结节增多 ,绒毛间腔狭窄可能是绒毛间质水肿所致 ,血中甘胆酸水平升高对绒毛组织有直接的不良作用 。
To observe the placenta morphologic changes of intrahepatic cholestasis of pregnancy (ICP) and disuss the association among the placenta pathology, clinical symptoms and fetal outcome.32 ICP p1acentae and l2 p1acentae from normal pregnancy as control were quantitatively analyzed with light microscopic norphometry. The relationship among the morphometrical indexes,the laboratory cholestasis indexes-serum glycocholic acid,SGPT,T-BI,D-BI and the fetal outcome were analyzed.The results showed that the placenta parenchyma volume ratio (V p) and intravillous space volume ratio (V IVS ) were significantly reduced compared with those in the control group, syncytial knot volume ratio (V ST ) were significant increased compared with the control group (p<0.05), and the changes of severe group were significant. Correlation analysis showed that V IVS 、V ST and villi volume ratio have significant relationship with serum ghycocholic acid (r=0.521, p<0.01; r=0.401, p<0.05; r=-0.328,p<0.05). V IVS have significant corre1ation with the degree of meconium staining in the amniotic fluid and the happen of fetal distress. Conclusions: the major morpho1ogic changes of ICP placenta are reduction of intravillous space and increase of syncytial knot. The villi hydrops may lead to intravillous space reduce, as well the ghycocholic acid may play a demagement role in these changes. Intravillous space reduction may be one reason of fetal distress in ICP.
出处
《中国体视学与图像分析》
2001年第1期6-12,共7页
Chinese Journal of Stereology and Image Analysis
