米非司酮药物流产后子宫出血的相关性研究

目的]探讨米非司酮药流产后子宫出血与蜕膜细胞凋亡、基质金属蛋白酶-3及其抑制物-1及子宫内膜自然杀伤(uNK)细胞等多种因素的相关性。方法]选取自愿终止妊娠的停经8周之内的早孕妇女,自愿选择药物流产或人工流产两种方法,分为人工流产组、药流不全组、药流完全组各20例。收集3组蜕膜组织进行福尔马林固定,石蜡包埋,应用免疫组织化学方法检测FasL、MMP-3、TIMP-1、CD56的表达,图象分析仪定量分析。结果]药流不全出血区FasL的表达显著减弱(P﹤0.01);MMP-3的表达强度显著增强(P﹤0.01);而TIMP-1的表达强度显著减弱(P﹤0.01);药流不全出血区uNK细胞的数量显著增多(P﹤0.01)。结论]药流不完全出血区的蜕膜细胞FasL表达减弱,未凋亡的蜕膜组织残留于子宫内,导致流产不全,引发出血;MMP-9增多,TIMP-1减少,且两者比例失调,导致细胞外基质退化,血管脆性增加,产生出血;另外uNK细胞数量异常增多,导致异常血管生成,孕囊与蜕膜剥离不全,从而引起出血。

THE RELEVANT FACTORS OF UTERINE BLEEDING FOLLOWING MIFESPRISTONE ABORTION

Objective]To study the relationship of uterine blooding following mifespristone abortion with cell apoptosis,matrix metalloproteiniase and it's inhibitors and the nature killer cells in endometrium(the uNK cells).Methods]Healthy pregnant women who were termination with gestational age less than 8 weeks were recruited.They chose medical or surgical abortion.They were divided into three groups:surgical abortion by vaccum aspiration group,incomplete abortion mifepristone group and complete abortion mifeprist...