米非司酮对人早孕绒毛、蜕膜组织血管生成的影响探讨

Probe into the Effect of Mifepristone on Angiogenesis of Human Chorionic Villi and Decidual Cells

目的:探讨米非司酮对早孕绒毛与蜕膜组织血管生成的影响。方法:取服米非司酮及米非司酮配伍米索前列醇后的早孕绒毛与蜕膜组织,以负压吸引流产术的绒毛与蜕膜组织为对照组,应用免疫组织化学技术,观察米非司酮对血管内皮生长因子(VEGF)与微血管密度(MVD)的影响。结果:服用米非司酮、米非司酮配伍米索前列醇后,绒毛、蜕膜组织的VEGF分别由对照组的1.61±0.65分、1.61±0.77分,下降至0.83±0.58分、0.83±0.39分和0.80±0.63分、0.70±0.67分(P<0.05);其MVD值分别由10.70±2.24个、28.08±8.81个,下降至5.25±1.95个、18.58±4.83个和4.30±1.06个、17.80±4.29个(P<0.001、P<0.01)。服用米非司酮与米非司酮配伍米索前列醇,绒毛、蜕膜组织VEGF与MVD值无显著性差异。结论:米非司酮使早孕绒毛与蜕膜组织的VEGF与MVD值下降,这可能是米非司酮终止早孕的机理之一。

Objective： To probe into the effect of mifepristone on angiogenesis of human chorionic villi and decidual cells. Methods ： Thirty - five specimens were obtained from pregnant women with amenorrhea of 5- 7 weeks duration. 12 women were treated with mifepristone and 10 cases were given mifepristone combined with misoprostol, while women administered with artificial abortion were as the control group. The levels of Vascular endothelial growth factor （VEGF） and microvascular density （MVD） of the specimens were assessed by immunohistochemistry for VEGF and CD34 antigen, and the effect of mifepristone on VEGF and MVD was observed. Results： The levels of VEGF in human chorionic villi and decidual cells administered with mifepristone（0.83 ± 0.58scores and 0.83 ± 0.39scores, respectively） or mifepristone combined misoprostol （0.80 ± 0. 63 scores and 0. 70 ± 0.67scores, respectively） were significantly decreased （ P 〈 0. 001 and P 〈0.05, respectively） comparing with the control group（ 1.61 ±0.65scores and 1.61 ± 0.77scores, respectively）. The levels of MVD in human chorionic villi and decidual cells administered with mifepristone （5.25 ± 1.95scores and 18.58 ±4.83scores, respectively） or mifepristone combined misoprostol（4.30 ± 1. 06scores and 17.80 ± 4.29scores, respectively） were also significantly decreased （ P 〈 0.001 and P 〈 0.01, respectively ） comparing with the control group（ 10.70 ± 2.24scores and 28.08 ± 8.81 scores, respectively）. However, no significant differences were showed between mifepristone and mifepristone combined misoprostol groups （P 〉 0.05 ）. Conclusions： Mifepristone can inhibit angiogenesis in human chorionic villi and decidual cells, which may he the mechanism of termination of early pregnancy by mifepristone.