黏液在羊水栓塞病理诊断中的价值

Value of mucus in the pathological diagnosis of amniotic fluid embolism

目的探讨黏液在羊水栓塞(amniotic fluid embolism,AFE)病理诊断指标中的价值。方法从12例AFE中提取15份标本(6例尸解、其中3例尸解同时取腔静脉血、6例腔静脉血)采用HE染色、黏液(p H 2. 5)染色及免疫组化En Vision法标记CKpan、CD34、CR,显微镜下观察、计数羊水有形成分。另收集15例作为对照组进行对比分析。结果在6例AFE尸解病例的肺小血管中及9例腔静脉血标本中检出不同比例的羊水有形成分,其中上皮占23. 56%,黏液占65. 60%,脂肪占1. 27%,胎粪占8. 91%,毳毛占0. 63%。5种有形成分的检出率总体比较,黏液(P <0. 001)、上皮(P <0. 001)、脂肪(P <0. 001)阳性检出物显著高于对照组,两者差异有统计学意义;胎粪(P=0. 430)及毳毛(P=0. 183)两者差异无统计学意义。结论 AFE的黏液检出率显著高于对照组,而在检出的羊水有形成分中黏液检出率较高,其在AFE病理诊断中有较高的应用价值。

Purpose To explore the value of mucus in the pathological diagnosis of amniotic fluid embolism(AFE).Method A total of 15 specimens were received in 12 cases of AFE,including 6 cases of autopsy tissues(plus cavity venous blood in 3 cases and 6 cases of cavity venous blood),and the amniotic fluid components were detected via HE staining,mucus(pH 2.5)staining,immunohistochemistry of EnVision method for CKpan,CD34 and CR.And the data were compared with that of 15 control specimens.Results Amniotic fluid components were detected with different rates in 6 pulmonary small blood vessels of AFE autopsy and 9 cavity venous blood samples,in which epithelium was noted in 23.56%,mucus 65.60%,fat 1.27%,feces 8.91%and hair 0.63%.By overall comparison of 5 kinds of amniotic fluid components,the detection rate of mucus(P<0.001),epithelium(P<0.001),fat(P<0.001)was significantly higher than that of control group,But there was no significant difference in that of feces(P=0.430)and hairs(P=0.183).Conclusion The mucus detected in AFE group is significantly higher than that of control groups,which is the highest in the detected amniotic fluid components,and therefore the mucus has high value in the pathological diagnosis of AFE.