米非司酮对早孕绒毛和蜕膜组织中诱导型一氧化氮合酶的影响

目的了解米非司酮对早孕绒毛、蜕膜组织中iNOS（iNOS）的影响，进一步探讨米非司酮早孕药物流产机制。方法采用原位杂交及免疫组化方法对40例药物流产的绒毛和蜕膜中iNOS的表达进行检测（实验组），利用计算机CMIAS系统，表达指标以数密度（N／S）及阳性单位（Pu）计算，并与40例正常人工流产的绒毛和蜕膜组织比较（对照组）。结果实验组绒毛组织iNOS原位杂交N／S、Pu分别为（0．12±0．01）、（15．3±2．6），对照组分别为（0．022±0．003）、（3．1±0．5），2组差异有统计学意义（P〈0．01）；免疫组化实验组和对照组N／S、Pu分别为（0．09±0．01）、（10．24±1．55）vs（0．016±0．002）、（1．26±0．33），差异有统计学意义。蜕膜组织中原位杂交及免疫组化iNOS表达较低，2组比较差异无统计学意义（P〉0．05）。结论米非司酮早孕药物流产与绒毛组织iNOS活性增加有关，与蜕膜组织iNOS表达无关。

The influence of mifepristone on inducible nitric oxide synthase in trophoblasts and deciduasin early medical abortion

Objective To investigate the influence of mifepristone on inducible nitric oxide synthase in trophoblasts and deciduas in early medical abortion,and the mechanism of medical abortion by mifepritone.Methods Expressions of iNOS in trophoblasts and deciduas were detected by in situ hybridization and immunohistochemical assay in 40 patients(experiment group).The positive expression of iNOS was represented by number density(N/S)and positive unit(Pu)using CMIAS program.All results were compared with that obtained from vacuum aspiration.Results In experiment group,N/S and Pu were 0.12±0.01,15.3±2.6 respectively in trophoblasts.While in controlgroup,it was 0.022±0.003 and 3.1±0.5 respectively.There were significant differences between the two groups.By immunohistochemical assay,N/S and Pu were 0.09±0.01 and 10.24±1.55 vs.0.016±0.002 and 1.26±0.33 in the two groups in trophoblasts,which were significantly different between the two groups.It showed lower expressions in deciduas by in situ hybridization and immunohistochemical assay,and no significant differences were observed between the two groups.Conclusions Mffepritone induces medical abortion through the expression of iNOS in trophoblasts but not in deciduas.