复方米非司酮对早孕绒毛、蜕膜形态学及雌、孕激素受体的影响

目的　观察早孕绒毛、蜕膜形态学及雌孕激素受体的表达 ,对复方米非司酮及米非司酮进行比较性研究。　方法　 4 9例早孕者随机分为对照、米非司酮 (15 0mg/次 )及复方米非司酮 (含双炔失碳酯 5mg +米非司酮 30mg ,12h× 2 ) 3组。服药后 2 4h手术终止妊娠 ,取绒毛、蜕膜组织 ,应用链霉卵白素 过氧化物酶 (SP)免疫组织化学法观察绒毛、蜕膜雌激素受体(ER)、孕激素受体 (PR)的变化。　结果　米非司酮组少数绒毛间质水肿变性 ,蜕膜示小灶性变性、坏死 ,可见凋亡细胞 ;绒毛ER、PR着染强度及阳性细胞着染百分率较对照组明显增加 (P <0 .0 0 1,P <0 .0 5 ) ,蜕膜ER、PR染色强度与对照组比较无显著差异 ,但阳性细胞着染百分率显著下降 (P <0 .0 5 ) ;复方米非司酮组绒毛表面附多量纤维蛋白样物 ,部分间质水肿 ,蜕膜呈片状变性、坏死 ,凋亡细胞散在 ;绒毛ER、PR着染强度较对照组显著增加 (P <0 .0 5 ) ,阳性细胞着染百分率与对照组比较ER显著增加 (P <0 .0 5 ) ,PR略低但无显著差异 ;蜕膜ER、PR着染强度无显著差异 ,但阳性细胞着染百分率与对照组比较明显下降(P <0 .0 0 1)。　结论　复方米非司酮使蜕膜ER、PR阳性细胞着染百分率明显降低 ,蜕膜变性、坏死较甚 ,但对ER、PR着染强度的影响相对小 ,这可能有助于提

The effects of compound mifepristone on morphology and estrogen and progesterone receptors in human villi and decidua

Objective: To investigate the effects of compound mifepristone and mifepristone on morphology and expression of estrogen receptor (ER),progesterone receptor (PR) in villi and decidua. Methods: 49 women with early pregnancy were randomly divided into three groups: group 1:18 cases served as control; group 2:16 cases administered mifepristone (150 mg) alone; group 3:15 cases administered compound mifepristone (anordrin 5 mg+mifepristone 30 mg,Q12 h×2 ).Twenty four hours after first medication, pregnancy was terminated by vacuum aspiration. Paraffin section with routine HE staining was used for morphological observation of villi and decidua. ER and PR in villi and decidua were determined by immunocytochemical technique. Results: Mifepristone treatment group showed edema in a few villi and small focal degeneration and necrosis in deciduas, but the normal structure still remained. Intensity percentage of positive staining cells of ER and PR increased significantly in villi than that in control, ER ( P <0.001), PR ( P <0.05); staining intensity of ER and PR in decidua was not significant when compared with control ( P >0.05),but percentage of positive staining cells decreased significantly ( P <0.05); compound mifepristone treatment group showed large amount of fibrinoid material adhered to the surface of villi, edema of partial villi, and also showed patchy degeneration , necrosis and apoptotic cells in decidua. Staining intensity and percentage of ER in villi increased significantly ( P <0.05),PR was not significant ( P >0.05). Staining intensity of ER,PR was not significant in decidua (P>0.05),but percentage of positive staining cells decreased significantly when compared with control and mifepristone groups ( P <0.001). Conclusion: The percentage of positive staining cells of ER and PR in deciduas decreased significantly, meanwhile, severer degeneration and necrosis were found in decidua in compound mifepristone group when compared mifepristone alone and control groups. These changes may benefit to enhance the rate of complete abortion and to promote endometrial repair.