胎儿生长受限胎盘组织中细胞凋亡与增殖

目的:通过对胎儿生长受限患者的胎盘组织细胞凋亡和增殖指数的测定,从细胞增殖与凋亡的角度阐述导致胎儿生长受限发生、发展的病理机制。方法:研究对象来自于2007年2月~2009年2月在该院分娩的胎儿生长受限患者31例(FGR组)和正常足月分娩30例(对照组)的胎盘组织。应用TUNEL法及SP法定量测定各种细胞的凋亡指数及增殖指数。结果:两组胎盘各细胞成分均有凋亡发生,细胞凋亡在两组中均以蜕膜细胞和合体滋养细胞为主。胎儿生长受限组〔合体滋养细胞凋亡指数(36.4±9.2)%,蜕膜细胞凋亡指数(40.2±7.5)%〕与对照组相比〔合体滋养细胞凋亡指数(23.3±5.0)%,蜕膜细胞凋亡指数(28.4±8.2)%〕凋亡明显增多,差异有统计学意义(P0.01)。在胎儿生长受限组细胞滋养细胞内有一定量的增殖细胞核抗原表达〔细胞滋养细胞增殖指数(25.1±5.9)%〕,和对照组相比〔细胞滋养细胞增殖指数(17.2±5.8)%〕细胞增殖明显,差异有统计学意义(P0.01)。结论:在胎儿生长受限及正常晚孕的胎盘中均存在凋亡现象。胎儿生长受限患者胎盘中合体滋养细胞及蜕膜细胞凋亡较正常晚孕明显增多,且细胞滋养细胞表现为明显增生,这可能是引起FGR发生、发展的重要病理过程。

Cell apoptosis and proliferation in placental tissues of fetal growth restriction

Objective:To expound the pathological mechanism of occurrence and development of fetal growth restriction from the standpoint of cell apoptosis and proliferation by detecting the apoptosis index and proliferation index of placental tissues in cases with fetal growth restriction.Methods:31 patients with fetal growth restriction and 30 normal term pregnant women delivered in the hospital from February 2007 to February 2009,their placental tissues were collected,the apoptosis index and proliferation index were detected by TUNEL method and SP method quantitatively.Results:Apoptosis occurred in placental tissues of both fetal growth restriction group and control group,especially in decidual cells and syncytiotrophoblast cells.The apoptosis indexes in placental tissues of fetal growth restriction group syncytiotrophoblast cells(36.4±9.2)%,decidual cells(40.2±7.5)%] were significantly higher than those in control group syncytiotrophoblast cells(23.3±5.0) %,decidual cells(28.4±8.2) %](P<0.01).The expression level of proliferating cell nuclear antigen in cytotrophoblastic cells of fetal growth restriction group proliferation index of cytotrophoblastic cells(25.1±5.9) %] was significantly higher than that in control group proliferation index of cytotrophoblastic cells(17.2±5.8) %](P<0.01).Conclusion:Apoptosis exists in placental tissues of patients with fetal growth restriction and normal women of late pregnancy;the apoptosis indexes in placental tissues(syncytiotrophoblast cells and decidual cells) of patients with fetal growth restriction are significantly higher than those in normal women of late pregnancy,and proliferation of cytotrophoblast cells in placental tissues is enhanced in patients with fetal growth restriction,which may probably play an important role in occurrence and development of fetal growth restriction.