不明原因胎儿宫内生长迟缓的胎盘病理及免疫因素探讨

【目的】观察不明原因IUGR的胎盘免疫病理改变及其与自身抗体的关系 ,探讨不明原因IUGR的发病机制。【方法】采用免疫组织化学方法对 2 2例不明原因IUGR和 2 3例正常产妇的胎盘进行免疫病理观察 ,并对两组的胎盘重量、胎盘系数、绒毛面积比及抗心磷脂抗体、抗核抗体进行比较。【结果】①IUGR组胎盘蜕膜血管免疫球蛋白IgG、IgM的阳性率均明显高于正常对照组。②IUGR组的胎盘绒毛血管IgM的阳性率高于对照组 ,而IgG的阳性率两组无差异。③IUGR组的胎盘重量、绒毛面积比均低于对照组 ,而胎盘系数大于对照组。④IUGR组ACA阳性率高于对照组。【结论】胎盘免疫复合物在胎盘血管中的沉积及ACA可能与不明原因IUGR的发生有关。

The Placental Pathology and Immune Factors of Idiopathic Intrauterine Growth Retardation

To observe the pathological changes and the immune complex distribution in placenta of idiopathic intrauterine growth retardation(IUGR). Using immunohistochemical technique (SP method), the deposition of IgG and IgM in the placenta of idiopathic IUGR patients was studied. The placental weight, placental ratio, villus area and the positive rate of ACA group were also compared between IUGR group and the control group. The positive rates of IgM in villous vessels, IgG and IgM in the decidual vessels in idiopathic IUGR group were higher than that in the control group. The pacental weight and villus area ratio in the IUGR group were smaller than that of the control group, while the placental ratio was higher than that of the control group. The of ACA positive rate in the idiopathic IUGR group was significantly higher than that of the control group. Conclusion] The immunopathological lesion in placenta vessels and ACA might have relation with the development of idiopathic IUGR.