米非司酮对早孕后期蜕膜及绒毛孕激素受体及细胞凋亡的影响

Effects on decidual and chorial progesterone receptor and apoptosis in the late stage of early pregnancy by Mifepristone

目的 探讨米非司酮对早孕后期蜕膜及绒毛孕激素受体 (PR)及细胞凋亡的影响。方法 取孕 7～12周人工流产 (对照组 )、顿服米非司酮 2 0 0mg后 2 4h流产及服药 4 8h后流产各 2 0例患者的蜕膜及绒毛 ,应用免疫组织化学方法 (ABC法 )测定PR含量 ;应用脱氧核糖核酸末端转移酶介导的缺口末端标记法测定比较细胞凋亡比率。结果 蜕膜组织PRH 积分对照组为 170 .33± 4 5 .71,服药 2 4h组为 16 3.5 5± 2 7.36 ,服药 4 8h组为 2 0 5 .2 9±34.0 4 ,后二组与对照组比较有显著性差异。对照组绒毛组织PR全部为阴性 ,服药 2 4h组 1例弱阳性 ,服药 4 8h组3例阳性 ;蜕膜细胞凋亡率对照组为 (0 .2 0 6± 0 .175 ) ,服药 2 4h组为 (0 .2 35± 0 .189) ,服药 4 8h组为 (0 .391± 0 .2 0 3) ,后者与对照组比较有显著性差异。绒毛细胞凋亡率对照组为 (0 .0 5 2± 0 .0 34) ,服药 2 4h组为 (0 .0 94± 0 .110 ) ,服药 4 8h组为 (0 .10 2± 0 .12 5 ) ,三组间差异无统计学意义。结论 米非司酮可以使蜕膜及绒毛中PR及细胞凋亡率升高 ,服药 4 8h比 2 4h作用更显著 ,其流产机制也可能作用于绒毛。

Objective To explore the effects of Mifepristone on decidual and chorial progesterone receptor (PR) and apoptosis in early pregnancy.Methods 20 decidual and chorial PR and apoptosis were observed respectively in abortion by suction evacuation(control),treated by Mifepristone 48 hours prior to admission and 24 hours prior to admission with imunoreactivity(ABC method) and terminal deoxynucleotidyl transferase mediated dUTP nick end labling (TUENL).Results Decidual RP H score in control was 170.33±45.71,in 24 hours prior was 163.55±27.36,in 48 hours prior was 205.29±34.04.There were significant difference between the latter and control.Chorial PR were negative in control,1 weakly positive in 24 hours prior and 3 positive in 48 hours prior.The rate of decidual apoptosis in control was 0.206±0.175,in 24 hours prior was 0.235±0.189,in 48 hours prior was 0.391±0.203.There were significant difference between the latter and control;The rate of chorial apoplosis in control was 0.052±0.034,in 24 hours prior was 0.094±0.110,in 48 hours prior was 0.102±0.125,There were no significant difference among the three groups.Conclusions Mifepristone could make decidual and chorial expres more PR,and enhence apoptosis in them.These effects came more significantly after 48 hours.During abortin,Mifipristone perhaps acted directly on chorial.