正常早孕与稽留流产绒毛组织结构中Bax和Bcl-2蛋白表达的对比研究

目的：研究凋亡调控蛋白Bcl-2和Bax在正常早孕与稽留流产绒毛组织结构中的表达及其意义，探讨稽留流产原因。方法选择本院就诊的稽留流产患者和早孕人工流产患者各60例，分为A组、B组。流产后立即留取胚胎绒毛组织送病理。分别应用光镜观察各组绒毛组织细胞形态结构的改变；同时应用免疫组织化学方法和计算机图文分析系统检测Bax、Bcl-2在各组绒毛的表达及细胞凋亡情况。结果稽留流产组绒毛滋养细胞中凋亡指数为（33.32±0.79）%，明显高于对照组B组的（18.90±0.63）%，差异有统计学意义（P〈0.01）。Bax和Bcl-2在两组合体滋养细胞中的阳性率比较显示，稽留流产组中Bax阳性率增高， Bcl-2阳性率下降， Bcl-2/Bax比值降低，差异均有统计学意义（P〈0.01）。结论蜕膜绒毛中Bax阳性率增高和Bcl-2阳性率下降可使绒毛合体滋养细胞凋亡明显增加，并进一步导致稽留流产发生。

Comparative study of Bax,Bcl-2 protein expression in villi structure during normal pregnancy and missed abortion

Objective To study apoptosis regulating proteins Bcl-2 and Bax in normal pregnancy and missed abortion villi structure and its significance, and explore the reasons for missed abortion. Methods Choose our hospital patients missed abortion and early pregnancy abortion patients, 60 cases in total, divided into group A and group B. Immediately after abortion, embryonic villi specimens sent to pathology. Light microscopy were applied in each group villi morphological changes in the structure, while applying immunohistochemical methods and computer image analysis system to detect Bax, Bcl-2 expression in each group villi and cell apoptosis. Results Missed abortion group trophoblast cell apoptosis index was （33.32±0.79）%, was significantly higher in group B（18.90±0.63）%, difference was statistically significant （P〈0.01）. Bax and Bcl-2 in the two groups syncytiotrophoblast cells show positive rate. In missed abortion group, Bax positive rate increased, Bcl-2 positive rate of decline, Bcl-2/Bax ratio increased, differences were statistically significant （P〈0.01）. Conclusion The increasing positive expression rate of Bax and the decreasing positive expression rate of Bcl-2 in decidua villi can lead to villous syncytiotrophoblast cells increased significantly,and further lead to missed abortion.