早孕胚胎胚外环境的临床研究

Clinical Study of the Circumstance of Embryo in Early Pregnancy

目的:研究早孕胚胎的胚外环境。方法:非意愿妊娠人工流产前在B超下对28例孕6～11周胚胎进行胚外体腔穿刺,抽取体腔液,同时抽取孕妇静脉血,其中8例同时穿刺羊膜腔抽取羊膜腔液,行生化检测。结果:母血中碱性磷酸酶(AKP)、总蛋白远高于胚外体腔液及羊膜腔液(P<0.01);Na^+、Cl^+、肌酐浓度也较高(P<0.05),K^+、Ca^(2+)浓度基本相似(P>0.05);葡萄糖浓度略高于体腔液(P<0.01),与羊膜腔液基本相似(P>0.05)。胚外体腔液蛋白浓度是羊膜腔液的3倍,Ca^(2+)及肌酐浓度也较高(P<0.05)。其余指标无显著性差异。结论:早孕阶段母体-绒毛间隙-羊膜囊存在交流,并呈现一定梯度,绒毛膜及羊膜起了半透膜的作用,限制营养物质交换和代谢,从而保持胚胎在早期发育中有相对稳定的内环境。

Objective： To explore the circumstance of embryo in early pregnancy. Methods： Some quantity of exocoelomic fluid was obtained by applying coelocentesis in unwilling early human pregnancy under continuous transvaginal ultrasonographic guidance among 28 cases of gestation 6-11 weeks, meanwhile venous blood was aspirated before abortion. Some quantity of amniotic fluid was aspirated by puncturing the amniotic cavity among 8 cases at the same time. Biochemical test was performed. Results： AKP and total protein levels were far higher （P 〈0.01） in the maternal serum than those in exocoelomic fluid and amniotic fluid as well as higher sodium, chlorine, creatinine levels （P〈0.01）. However, there were no obvious disparities in potassium and calcium levels （P〉0.05）. Higher glucose level was found in the maternal serum than in the exocoelomic fluid （P〈0.01）, but similar glucose level was found in amniotic fluid （P〉0.05）. The level of total protein in exocoelomic fluid was 3 times as high as that in amniotic fluid （P〈0.05）. Significantly higher calcium and creatinine levels in exocoelomic fluid were also found（P〈 0.05）. There were no statistical differences among other items. Conclusion： The interaction exists among maternal body-gap of villi-amniofic sac, which makes the exchange of substances some extent of a stairway, Villous membrane and amniotic membrane act as a kind of semi-permeable membrane, which limits the nutrients exchange and metabolism. It results in a relatively stable inner circumstance during early development of the embryo.