米非司酮服用后不同时点早孕妇女绒毛组织形态及雌、孕激素受体表达观察

Changes in morphology of chorion tissue and expression of estrogen receptor and progesterone receptor in early pregnant women at different time points after taking mifepristone

目的观察米非司酮服用后不同时点人早孕绒毛组织形态及雌激素受体(ER)、孕激素受体(PR)表达变化。方法自愿要求终止早期妊娠的女性80例,随机分为对照组、12 h组、24 h组、48 h组各20例。12 h组、24h组、48 h组口服米非司酮150 mg,分别于服药12、24、48 h后施行负压吸引术,留取各组吸宫术后的绒毛组织。对照组未服用任何药物,直接采用常规负压吸引术终止妊娠。光镜、透射电镜下观察四组绒毛组织形态学及超微结构改变,采用免疫组化法检测各组绒毛组织中的ER、PR。结果 12 h组、24 h组、48 h组绒毛滋养层细胞变性、坏死甚至脱落,炎症细胞浸润,绒毛间质水肿,细胞超微结构破坏。对照组、12 h组、24 h组、48 h组绒毛组织中ER相对表达量分别为0.182 4±0.007 2、0.119 1±0.005 9、0.120 8±0.011 0、0.121 2±0.007 3,各组绒毛组织中PR相对表达量分别为0.179 0±0.008 2、0.132 7±0.007 0、0.128 5±0.006 5、0.126 2±0.010 9,12 h组、24 h组、48 h组ER、PR相对表达量与对照组相比,P均<0.05。结论米非司酮作用后12 h绒毛组织发生变性坏死,ER、PR表达受到抑制。

Objective To observe the changes in morphology of chorion tissue and expression of estrogen receptor（ ER） and progesterone receptor（ PR） in early pregnant women at different time points after taking mifepristone. Methods Eighty women who desire to terminate the early pregnancy were randomly divided into the control group,12-hour group,24-hour group and 48-hour group,and each group contained 20 cases. Women in the 12-hour group,24-hour group and48-hour group took 150 mg mifepristone. Negative pressure suction were performed after 12,24 and 48 hours respectively in the three groups. The chorion tissue were collected after suction. We observe the morphological change of chorion tissue by light microscope and transmission electron microscope. Detecting the expression of ER and PR in the chorion tissue by immunohistochemistry. Results Three medication groups showed the cell degenerated,some were necrotic,even fell off,the inflammatory cell infiltrated,the chorion interstitial had edema and the ultrastructure was damaged. The relative expression levels of ER in the control group,12-hour group,24-hour group and 48-hour group were 0. 182 4 ± 0. 007 2,0. 119 1± 0. 005 9,0. 120 8 ± 0. 011 0 and 0. 121 2 ± 0. 007 3. The relative expression levels of PR were 0. 179 0 ± 0. 008 2,0. 132 7 ± 0. 007 0,0. 128 5 ± 0. 006 5 and 0. 126 2 ± 0. 010 9. Significant differences were found in the ER and PR between the three medication groups and control group（ all P〈0. 05）. Conclusion The chorion tissue degenerates and shows necrosis and the expression of ER and PR is inhibited after taking mifepristone twelve hours.