血管内皮细胞生长因子及血管生成素Ⅰ和Ⅱ在药物流产宫腔残留蜕膜组织中的表达

目的研究血管内皮生长因子（VEGF）、血管生成素I（Ang—Ⅰ）和Ang-Ⅱ在药物流产异常子宫出血者子宫内膜组织中的表达，探讨其与异常子宫出血的关系。方法20例药物流产后异常子宫出血者官腔刮出物行病理学检查，另外选取20例药物流产后无异常出血者的宫腔排出物及20例早孕人工流产者的官腔刮出物做对照，应用免疫组织化学方法检测3组子宫内膜组织中VEGF、Ang—Ⅰ、Ang-Ⅱ的阳性表达率和表达强度的差异。结果Ang-Ⅰ、Ang-Ⅱ蛋白在药物流产后的子宫内膜组织的腺上皮及内膜基质细胞和血管壁中均有表达，以在腺体表达为主；异常出血组VEGF、Ang—Ⅰ和Ang-Ⅱ的表达强度较药物流产无异常出血组增高，差异有统计学意义，与早孕手术流产组比较，差异无统计学意义。结论药物流产后绒毛和蜕膜的残留可能是导致患者出血时间延长和出血量多的主要原因；药物流产后异常子宫出血者子宫内膜中Ang的表达增强，可能引起血管生成的异常，从而使绒毛和蜕膜不容易脱落或子宫内膜的修复受影响，导致出血时间延长。

Expression of vascular endothelial growth factor and angiopoietin-I and II in deeidual residue after medical abortion

Objective To investigate the expression and the roles of vascular endothelial growth factor （ VEGF）, Angiopoietin I （Ang-I） and Angiopoietin II （Ang-II） in the endometrium of women with abnormal bleeding after medical abortion. Methods Endometrial pathological change of 20 patients with abnormal bleeding after medical abortion in early pregnancy were analyzed. The endometrial specimens from 20 women without abnormal bleeding after medical abortion and 20 women with selective termination of normal pregnancy were used as control groups. Immunohistochemistry was used to detect the levels of VEGF, Ang-I and Ang-II proteins in endometria. Results Positive immunoreactive signals of Ang-I and Ang-II were found in the endometrial glandular epithelium, stromal cells and the endothelial ceils of vessels. The expression rates of VEGF, Ang-I and Ang-II in the patients with abnormal bleeding were higher than those in the second group, but were the same as the third group. Conclusion The residual decidua and villus are probably the main cause of abnormal bleeding after medical abortion. The hyperexpression of Ang-I and Ang-II in the endometrium of patients with abnormal bleeding after medical abortion may play an important role in the process of residual deeidua and villus.