米非司酮抗早孕蜕膜雌,孕激素受体的免疫组织化学研究

目的了解米非司酮及米索前列醇（米索）对人早孕蜕膜雌激素受体（ＥＲ）、孕激素受体（ＰＲ）的影响。方法取正常早孕、服米非司酮及服米非司酮配伍米索后各１０例的蜕膜,应用单克隆抗体链菌素亲生物蛋白过氧化酶（ＳＰ）免疫组织化学方法及电子计算机图象分析技术,观察ＥＲ、ＰＲ的变化。结果正常早孕蜕膜ＥＲ和ＰＲ位于大部分蜕膜间质细胞及少数腺上皮细胞胞核内,受体水平积分ＥＲ为５８６０７９０±３１１６９１,ＰＲ为４９０５９７０±１５７３１９;服米非司酮后蜕膜ＥＲ、ＰＲ水平积分为３５４７１８０±１９１８５８、３７００７５０±１８８３２２;服米非司酮配伍米索后蜕膜ＥＲ和ＰＲ水平积分为２０２１７２１±１４５２８１、２５２８５８０±２４０５３５。３者间差异有显著性（Ｐ＜０．０５,Ｐ＜０．０１）。结论米非司酮及米索可使早孕蜕膜ＥＲ、ＰＲ水平下降,这可能与药物流产后子宫出血时间长有关。

The immunohistochemical studies on estradiol and progesterone receptors in human decidua after terminating early pregnancy by mifepristone

Objective To investigate the effects of mifepristone on decidua at the cellular level of estrogen receptor (ER) and progesterone receptor(PR) and the mechanism of prolonged uterine bleeding after terminating early pregnancy by mifepristone. Methods Thirty decidua specimens were obtained from pregnant women with amenorrhea of 67 week duration, 20 women were treated with mifepristone and 10 given mifepristone plus misoprostol respectively. Immunocytochemical reactions of PR nad ER in decidua were compared among three groups using computer image analysis technology. Results In the control group,the nuclei of the decidual cells were stained positively for ER and PR. Their integral values of receptor level were 5 860 790311 691 for ER and 4 905 970157 319 for PR.Mifepristone treatment reduced ER and PR staining.The integral values were 3 547 180191 858 for ER and 3 700 750188 322 for PR in this group, and it was more apparent in the group treated with mifepristone plus misoprostol:2 021 721145 281 for ER and 2 528 580240 535 for PR. Conclusions The ER and PR level in human decidua decreased after mifepristone or/and misoprostol treatment. This may be related to prolonged uterine bleeding after terminating early pregnancy by mifepristone