三苯氧胺联合米非司酮对ICAM-1、LIF在早孕绒毛中表达的影响

目的:检测3组早孕流产绒毛组织中的细胞间黏附分子-1(ICAM-1)、白血病抑制因子(LIF)的表达,探讨三苯氧胺联合米非司酮缩短流产出血时间的可能作用机理,为临床预防和治疗药物流产后出血提供理论依据。方法:随机将非意愿妊娠7周内要求药物流产的宫内早孕妇女80例分成2组:三苯氧胺联合米非司酮+米索前列醇组(A组);米非司酮+米索前列醇组(B组)。40例人工流产手术为对照组(C组)。应用West-ern blot及实时定量PCR方法分别检测绒毛组织中ICAM-1、LIF的蛋白及mRNA的表达。结果:A组的平均出血时间较B组短,C组出血时间最短。A组绒毛组织中ICAM-1、LIF蛋白及mRNA的表达量最低,B组绒毛组织中ICAM-1、LIF蛋白及mRNA的表达量稍高,C组绒毛组织中ICAM-1、LIF蛋白及mRNA的表达量最高。结论:三苯氧胺可协同米非司酮加强ICAM-1和LIF的表达下调,推测三苯氧胺联合米非司酮缩短药物流产出血时间可能与ICAM-1和LIF的表达变化有关。

Study of the effect of tamoxifen combined with mifepristone on expression of ICAM-1,LIF in human villous tissue in early pregnancy

Objective: To observe the different expression of ICAM-1 and LIF in the villus of different groups,include two different medical abortion groups and an induced abortion group.To explore the possible mechanism of shortening the bleeding time after the abortion by using Tamoxifen combined with mifepristone,and then provide the theoretical basis for the clinical prevention and medical treatment of bleeding after abortion.Methods:80 women who were unwanted pregnancy within seven weeks and required medical abortion,were randomly divided into two groups,patients treated with tamoxifen combined with mifepristone and misoprostol were classified as A group which contain 40 cases,and the residues were classified as B group which were treated with Mifepristone and misoprostol.Additionally,an induced group who required artificial abortion operation was included as a control group(C group) which contains 40 cases.Western blot and real-time quantitative PCR were used to detect the expression level of protein and mRNA of ICAM-1 and LIF respectively in the Villus.Results:The results of the statistical analysis to the bleeding time of the different show as fellows:the average bleeding time of A group was shorter than B group.The average bleeding time of C group was shortest.The expression of ICAM-1 and LIF in the Villus of A group was the least in three groups;The expression of them in the Villus of B group was slightly higher than that in the Villus of A group;the expression of ICAM-1 and LIF in the Villus of C group was the greatest.Conclusion:Tamoxifen may enhance the effect of down-regulation of ICAM-1、LIF by Mifepristone in the Villus,tamoxifen combined with mifepristone can shorten the bleed duration after drug abortion and present a prospect of clinical application.