米非司酮对人胎肺组织超微结构的影响

Effects of mifepristone on ultrastructure of human fetal pulmonary tissue

目的：探讨米非司酮对胎肺组织超微结构的影响。方法：将具有终妊指征的中孕病例分为米非司酮组与对照组，每组各５ 例，孕周为１８ ～２１ 周。米非司酮组在引产前６ ｈ 服用１５０ ｍｇ 米非司酮，然后行水囊引产术，对照组则只行水囊引产术。胎儿娩出后即取肺组织进行样品制备，以供电镜观察。结果：与对照组相比较，米非司酮组的胎肺组织可见：１－ 终末及呼吸细支气管上皮及肺泡上皮细胞糖原空白区增多和增大。２－ 肺组织的神经内分泌细胞较常见。３－ 终末及呼吸细支气管腔及肺泡内脱落或残缺的上皮细胞常见，偶见红细胞。４－ 间质水肿明显，微血管缺损，可见大量红细胞渗出。结论：米非司酮可造成胎肺组织缺氧性损伤。因此，使用米非司酮于晚期引产有可能给新生儿留下肺功能损伤的后遗症。

AIM: To investigate the influence of mifepristone on ultrastructure of human fetal pulmonary tissue. METHODS: 10 pregnant women (gestational duration ranged from 18 to 21 weeks) with indications of pregnancy termination were recruited and randomly divided into 2 groups. Mifepristone group ( n =5),150 mg mifepristone per os was given six hours before labor induction, control group ( n =5), labor induction was performed by extra-amniotic insertion of waterbag only. Immediately after delivery of fetus, pulmonary tissue was acquired and prepared for electron microscopic examination. RESULTS: In comparison with the control group, the pulmonary tissue of mifepristone group displayed the following morphological changes: 1. The glycogen depleted areas in epithelium of terminal and respiratory bronchioles and alveoli were increased both in the number and size. 2. The pulmonary neuro-endocrine cells appeared frequently. 3. Many disintegrated or fragmentary epithelial cells as well as some red cells were observed in the bronchial and alveolar lumen. 4. The interstitium was markedly edematous, capillaries were damaged and the extravasal red cells were often seen. CONCLUSIONS: Mifepristone may cause a hypoxic damage in the fetal pulmonary tissue. Therefore, using mifepristone for labor induction in full term pregnancy might leave a pulmonary insufficiency for the new born infants.