血清TNF-α变化及蜕膜和绒毛细胞凋亡与药物流产结局的关系

Relationship of serum tumor necrosis factor-alpha and apoptosis of decidual and chorionic cells to the outcome of medical abortion

目的探讨血清TNF-α水平变化及蜕膜、绒毛细胞凋亡对米非司酮药物流产结局的影响。方法对80例选择药物流产的早期妊娠妇女于服药前及服药后孕囊排出(药物流产成功组66例)时或服药后10h仍无孕囊排出(药物流产失败组14例)时分别进行血清TNF-α水平测定。分别随机抽取药物流产成功组及失败组各10例患者的蜕膜及绒毛组织采用TUNEL法检测细胞凋亡水平,并以相同条件下直接行人工流产者(对照组10例)做对照。结果服药后与服药前比较,药物流产成功组血清TNF-α水平明显升高(P<0.05),而药物流产失败组血清TNF-α水平无明显变化(P>0.05)。与早期妊娠行人工流产的对照组比较,药物流产成功组的蜕膜、绒毛细胞凋亡指数均明显增加(P<0.01),药物流产失败组的蜕膜、绒毛细胞凋亡指数均无明显变化(P>0.05)。结论血清TNF-α水平变化及蜕膜和绒毛细胞凋亡与米非司酮药物流产结局有关。

Objective To study the influence of serum tumor necrosis factor-alpha and apoptosis of decidual and chorionic cells on the outcome of medical abortion with mifepristone.Methods In 80 early pregnancy women who had chosen medical abortion,the level of serum tumor necrosis factor-alpha was determined before medication and after the discharge of gestational sac （belonging to the success group of medical abortion） or at 10 hours if no gestational sac discharged （belonging to the failure group of medical abortion）,respectively.In both the success and failure group,10 cases of decidual and chorionic cells were chosen at random to examine the apoptotic level by the method of TUNEL,and additional 10 women who had directly chosen artificial abortion in the similar conditions were selected as control.Results After medication,in comparison with before,the level of serum tumor necrosis factor-alpha in the success group rose obviously （P〈0.05）,while in the failure group,it didn′t change significantly （P〉0.05）.Compared with the control group,the both apoptotic indexes of decidual and chorionic cells in the success group were markedly increased （P〈0.01）,but those in the failure group showed no significant differences （P〉0.05）.Conclusions The change of serum tumor necrosis factor-alpha and the apoptotic level of decidual and chorionic cells are related to the outcome of medical abortion with mifepristone.