米非司酮对分泌早期人子宫内膜超微结构的影响

目的:探讨米非司酮对分泌早期人子宫内膜超微结构的影响。方法:子宫内膜组织取自10例排卵后1周内因非子宫内膜原因的疾病而接受子宫切除的育龄妇女。任选5例在手术前24 h口服米非司酮25 mg(米非司酮组), 其余5例未服药者为对照组。子宫内膜组织经常规电镜样品制备后, 进行电镜观察。结果:与对照组相比, 米非司酮组的子宫内膜出现下列明显的形态改变:(1)在腺上皮未见核仁管道系统及巨大线粒体, 核下糖原聚集少见, 但是, 巨大溶酶体常见; (2)腺上皮细胞间隙窄直, 侧膜褶迭少见; (3)基质细胞常出现溶解或核固缩, 并有红细胞渗出。结论:米非司酮引起的上述子宫内膜分泌早期形态改变势必造成胚泡植入的困难, 因而达到紧急避孕的效果。

Effects of mifepristone on ultrastructure of human endometrium in the early secretory phase

AIM: To investigate the influence of mifepristone on ultrastucture of human endometrium in the early secretory phase. METHODS: Endometrial tissue was obstained from 10 patients of reproductive age, who underwent a hysterectomy within 1 week postovulatory for gynecologic diseases not involving the endometrium. Patients were divided into mifepristone group ( n =5) and control group ( n =5) randomly. Each patient in the mifepristone group had taken 25 mg mifepristone per os 24 h before the operation was performed, while none of the control group had taken mifepristone. After removal of uterus, endometrial tissue was immediately acquired and prepared for electron microscopic examination. RESULTS: In comparison with the control group, the endometrial tissue in mifepristone group displayed the following distinctly morphological changes: (1) In the endometrial epithelium neither nucleolar channel system nor giant mitochondrium was seen, and subnuclear glycogen accumulation was seldom observed, but giant lysosomes were frequently found. (2) The intercellular spaces of the epithelium were narrow and straight, the indigitations of lateral plasma membranes were rarely visible. (3) Cytolysis and karyopyknosis of stroma cells and extravasal red cells were repeatedly observed. CONCLUSION: The above mentioned morphological changes in endometrium in the early secretory phase caused by mifepristone are undoubtedly sufficient to prevent implantation. Consequently, mifepristone may have a contraception effect.