层粘连蛋白及纤维粘连蛋白与药流后子宫出血关系的研究

为探讨层粘连蛋白 (LM)及纤维粘连蛋白 (FN)在米非司酮药物流产 (以下简称药流 )后子宫持续出血时的表达 ,对 2 0例米非司酮 +米索前列醇药物流产后子宫出血 (出血组 )的刮出组织及 1 0例人工流产负压吸宫术吸出的组织 (对照组 ) ,用HE及免疫组织化学方法染色并观察标本。结果 :出血组的刮出组织中 4 5%可见滋养细胞或绒毛 ,90 %发现蜕膜组织。 2组蜕膜组织的血管及腺上皮基膜、蜕膜细胞周围和一部分蜕膜细胞胞质内都含有较丰富的LM与FN ,并且 2组间比较 ,FN与LM含量表达无明显差异 (P >0 .0 5)。说明残留蜕膜中含有能分泌大量LM与FN的蜕膜细胞和血管 ,致使蜕膜组织与子宫壁牢固地结合而不易脱落 ,影响内膜发育而引起出血。

Fibronectin and Laminin Expressions in Prolonged Uterine Bleeding after Medical Abortion

To investigate the expression of fibronectin(FN) and laminin(LN) in prolonged uterine bleeding after mifepristone induced abortion, 20 specimens from curettage were obtained from 20 women who had prolonged uterine bleeding after termination of early pregnancy by mifepristone and misoprostol. Ten specimens from normal early pregnancy by suction aspiration served as control group. All samples were studied by immunochemical stainning. Trophoblasts or villi were presented in 45% of the cases with prolonged bleeding, and retained decidua cells were shown in 90%. By immunochemical stainning, LM and FN were both significantly expressed around the decidual cells and in the base membrane of blood vessels and glandular epithelium; and also within some of the decidual cells. The expression levels at the three locations had no significant differences between the 2 groups ( P >0.05). The result illustrated that the retained decidua cells kept the function of secreting FN and LM, which served as the adhesion molecules to the uterine wall, thus caused prolonged uterine bleeding and postponed the regeneration of endometrium development.