重度妊高征胎盘组织病理学与形态计量学观察

为探讨妊高征胎盘床血管和胎盘绒毛的组织结构特点及其与妊高征发病机制的关系。本文应用图像分析系统对２９例重度妊高征（妊高征组）和２９例正常妊娠（正常组）的子宫胎盘床血管和胎盘绒毛进行了形态计量学检测。结果显示∶１妊高征组胎盘的重量、大小均显著低于正常组（Ｐ＜００５）。２妊高征组胎盘绒毛具有合体细胞结节、细胞滋养细胞、绒毛基底膜增厚和纤维素样坏死的绒毛数显著高于正常组（Ｐ＜００５），而具有血管合体细胞膜的绒毛数显著低于正常组（Ｐ＜００５）。３妊高征组胎盘的游离绒毛直径、周长和面积均比正常组显著减小（Ｐ＜００５）。４妊高征组子宫胎盘床螺旋动脉妊娠生理性改变缺乏，管壁增生肥厚、纤维素样坏死和动脉粥样硬化的发生率显著高于正常组（均Ｐ＜００５）。提示妊高征子宫胎盘床血管病变在妊高征发病中可能起重要作用，而胎盘绒毛的组织形态学变化是胎盘缺血、缺氧的结果

Placental histopathological and morphometric observations in severe pregnancy induced hypertension

To study on the pathological characteristics of the uteroplacental bed and placental villus in severe pregnancy induced hypertension (SPIH)and the relationship to the pathogenesis of PIH,29 cases with SPIH and 29 cases of normal term pregnancies (NTP)were observed morphometrically for the vessels of uteroplacental bed and placental villus by image analysis.Results:(1)The placental weight and size in SPIH were significantly lower than those in NTP(P<0 05 for all).(2)The numbers of the placental villi with the syncytial knots,cytotrophoblasts,thickening of basal lamina and fibrinoid necrosis in SPIH were significantly higher than those in NTP (P<0 05 for all).And the numbers of the placental villi with the vasculo-syncytial membranes in SPIH were significantly lower than those in NTP(P<0 05).(3)The diameter,perimeter and area of the placental villus in SPIH were significantly lower than those in NTP(P<0 05 for all).(4)The incidence of the deficiency of physiological changes in the spiral arteries of the uteroplacental bed,and the thickening,fibronoid necrosis,acute arterial atherosis of the vessels in SPIH were significantal higher than those in NTP(P<0 05 for all).It is suggested that the pathological changes of the spiral arteries of uteroplacental bed may play an important role in the PIH development,and the pathologic changes of the placental villus may be resulted from the placental ischemia and hypoxia.