米非司酮对早孕胎盘绒毛诱导型一氧化氮合酶和细胞凋亡的影响

目的了解米非司酮对早孕绒毛诱导型一氧化氮合酶（iNOS）及滋养层细胞凋亡的影响，进一步探讨米非司酢早孕药物流产机理。方法选择40例早孕药物流产患者（实验组），采用原位杂交及免疫组化方法检测绒毛中iNOS的表达，细胞凋亡采用3＇-OH末端缺口标记法（TUNEL）显示绒毛滋养细胞中原位凋亡细胞的表达。利用计算机图象分析系纺（CMIAS），iNOS表达指标以数密度（N／S）及阳性单位（Pu）计算，细胞凋亡以每个统计场凋亡细胞个数（N）、凋亡细胞平均噘光度（OD）、凋亡细胞面密度（凋亡细胞面积／统计场面积，DS／TS）表示，并与40例正常人工流产的绒毛和蜕膜组织（对照组：比较。结果实验组绒毛组织iNOS原位杂交结果显示N／S、Pu分别为0．12±0．010、15．3±2．6，对照组分别为0．02±0．003、3．1±0．5，两组有极显著性差异（P〈0．01）；免疫组化结果显示实验组和对照组N／s、Pu分别为0．09±0．01、10．24±1．55及0．016±0．002、1．26±0．33，差异有显著性。实验组绒毛滋养细胞凋亡指数显著增高，各指标两组比较差异显著。结论米非司酮早孕药物流产与绒毛组织iNOS活性及滋养细胞凋亡有关。

Effect of mifepristone on inducible nitric oxide synthase and apoptosis of placental villi during early pregnancy

Objective： To investigate the influence of mifepristone on inducible nitric oxide synthase and apoptosis of placental villi in first trimester medical abortion. Methods： Forty medical abortion patients were recruited in experiment group. Expression of iNOS in trophoblasts was detected by in situ hybridization and immunohistochemical assay. The trophoblast cells apoptosis was detected by TdT-medtianted dUTP-X nick end labeling（TUNEL）. The positive signal of iNOS was represented by number density（N/S）and positive unit（Pu）, while apoptosis was represented by positive cell number（N）, light density（OD）, square density（apoptosis cells square/statistic square,DS/ TS） using computer CMIAS. All results were compared with that obtained from forty vacuum aspiration patients（control group）. Results： In experiment group, N/S and Pu in trophoblasts were 0. 12 ± 0. 01 and 15.3 ± 2.6 respectively, while they were 0.02±0. 003, 3.1±0.5 respectively in control group. There was significant difference between the two groups. By immunohistochemical assay, N/S and Pu in trophoblasts were 0.09±0.010, 10. 24±1.55 vs 0.02±0.002, 1.26±0.33 in the two groups. There was also significant difference in apoptosis between the two groups.Conclusions： First trinester medical abortion by mifepristone may be through the expression of iNOS and apoptosis in trophoblasts.