妊娠早期复发性流产患者妊娠组织增殖与凋亡的研究

A Study on Proliferation and Apoptosis of Pregnancy Tissues in Early Recurrent Spontaneous Abortion Patients

目的分析妊娠早期复发性流产(recurrent spontaneous abortions,RSA)患者妊娠组织(绒毛滋养细胞及蜕膜细胞)增殖与凋亡的情况,并探讨其可能致病机制。方法选取我院2014年1月—2015年12月妇产科收治的妊娠12周内的RSA患者60例(RSA组),药物流产者60例(药物流产组),人工流产者60例(人工流产组)。采用DNA缺口原位末端标记技术检测3组胎盘绒毛组织和蜕膜组织细胞凋亡情况,采用免疫组织化学染色法检测3组胎盘绒毛和蜕膜组织中胎盘生长因子(placenta growth factor,PLGF)和凋亡相关因子Caspase-3的表达水平,并进一步分析RSA组中二者表达的相关性。结果 RSA组胎盘绒毛及蜕膜组织凋亡指数(apoptotic index,AI)均明显高于药物流产组和人工流产组,差异均有统计学意义(P均<0.01)。RSA组胎盘绒毛组织和蜕膜组织中PLGF表达水平均显著低于药物流产组和人工流产组(P<0.01),Caspase-3表达水平均显著高于药物流产组和人工流产组(P<0.05)。相关性分析显示,RSA组胎盘绒毛及蜕膜组织中Caspase-3与PLGF的表达呈负相关(r=-0.891,P=0.004;r=-0.927,P=0.001)。结论妊娠早期RSA的发生可能与绒毛组织和蜕膜组织中,PLGF的表达不足导致绒毛及蜕膜细胞增殖障碍,以及Caspase-3表达增加导致绒毛及蜕膜细胞过度凋亡有关。

Objective To analyze proliferation and apoptosis conditions of pregnancy tissues （villi nutrient and decidua cells） in early recurrent spontaneous abortion （RSA） patients and to investigate the possible pathogenic mechanisms. Methods A total of 60 early RSA patients within 12 weeks of pregnancy （group A）, medical abortion of 60 patients （group B） and 60 patients with induced abortion （ group C） during January 2014 and December 2015 were recruited in this study. In three groups, apoptosis conditions of villi nutrient cells and decidual ceils were detected by using DNA in situ end labeling method, and then expressions of placenta growth factor （PLGF） and apoptosis related factors Caspase-3 were detected by using immunohistochemical staining method. The correlation between PLGF and Caspase-3 expressions was analyzed in group A. Results In group A, values of apoptosis index （AI） of villi and decidual cells were significantly higher （P 〈 0.01 ） ; expressions of Caspase 3 and PLGF were significant lower （ P 〈 0.0l ） , and Caspase-3 expressions in villi and decidua cells were significantly higher than those in group B and C （P 〈 0.05）. Correlation analysis showed that Caspase-3 and PLGF expres- sions were negative correlation in group A （ r = - 0. 891, P = 0. 004 ; r = - 0. 927, P = 0. 001 ）. Conclusion The pathogen- esy of early RSA may be related to proliferation disorder of villi and decidua cells induced by PLGF poor expression and exces- sive apoptosis of viili and decidua cells induced by increasing Caspase-3 expression.