复方米非司酮对人早孕绒毛和蜕膜组织结构和分泌功能的影响

目的 :探讨复方米非司酮的抗早孕作用及机理。方法 :采用光镜、电镜和放免方法观察复方米非司酮对人早孕绒毛蜕膜组织结构和分泌功能的影响。结果 :( 1 )服药 2 4h后 ,光镜观察发现 ,绒毛和蜕膜组织灶性、片状变性 ,复方米非司酮组改变尤甚。超微结构改变表现为绒毛合体滋养细胞表面微绒毛稀少 ,胞浆内细胞器退化 ,复方米非司酮组胞质内可见大量空泡 ;蜕膜颗粒细胞中的高电子密度物质减少 ,腺上皮细胞顶浆分泌突起少且小 ,溶酶体增多 ,出现大量空泡 ,蜕膜细胞病变较轻。 ( 2 )服药 2 4h,绒毛和 /或蜕膜组织中的h CG、PRL、E2 、P水平明显下降 ( P<0 .0 1或 P<0 .0 5) ,PGF2α明显增高 ( P<0 .0 1 ,P<0 .0 5) ;E2 / P比值增加 ( P<0 .0 1 ,P<0 .0 5)。结论 :复方米非司酮通过影响绒毛和蜕膜组织结构和分泌功能而终止早孕 ,双炔失碳酯和米非司酮在人类也有协同抗早孕作用 ,绒毛和蜕膜是其抗早孕时主要作用部位之一。

Effects of Compound Mifepristone on the Morphology and Endocrine Function of Chorion and Decidua in Early Human Pregnancy

Objective: To explore the effecrs of compound mifepristone on terminating pregnancy and to investigate the mechanisms of anti-gestational action. Methods: The morphology and endocrine fuction of chorion and decidua in early human pregnancy were observed by using light microscope, electronic microscope and RIA. Results: (1) Compound mifepristone and mifepristone caused chorion and decidua degeneration. The ultrastructure of syncytiotrophoblast showed rare microvilli and degenerated organellae and a lot of vacuoles after administering compound mifepristone. The specific granules of the endometria granulocytes were obviously reduced, meanwhile, together with underdevelopment of apocrine gland, increase of lysosome and vacuole. The rough endoplasmic reticulum in decidual cells was swelling and primary lysosome appeared in decidual cells. (2) The production of hCG, PRL, E 2 and P from chorionic and/or decidual tissue 24 h after compound mifepristone and mifepristone treatment decreased significently and the production of PGF 2α and the ratios of E 2/P increased significantly (P<0.01 or P<0.05).Conclusion: The anti-gestational function of compound mifepristone may act by affecting the morphology and endocrine function of chorion and decidua in early human pregnancy. Mifepristone had synergism with anordrin in terminating human pregnancy with chorion and decidua being primary sites of effects.