米非司酮对胎儿外周血淋巴细胞表型和组织超微结构的影响

目的:研究米非司酮所致胎儿淋巴细胞表型及组织超微结构的变化,并探讨米非司酮对胎儿安全性的影响。方珐:妊娠22-24周要求引产的健康妇女30例,随机分为实验组和对照组。实验组顿服米非司酮150 mg,24 h后行水囊引产,对照组单纯水囊引产。然后取脐动脉血,应用流式细胞术(FCM) 分析淋巴细胞表型;透射电镜下观察胎儿心、肝、肺及肾组织超微结构的变化。结果:实验组CD8+、CD122+ 细胞和NK细胞百分率均显著低于对照组(P<0.01);而CD4+/CD8+比值则高于对照组(P<0.01);两组比较, CD3+细胞、CD4+细胞及CD25+细胞百分率差异无统计学意义(P>0.05)。超微结构研究表明,实验组胎儿心肌、肾小球出现明显病理变化,而肝、肺组织变化轻微。结论:米非司酮可导致胎儿免疫抑制功能减弱,免疫排斥功能增强,对胎儿心脏及肾脏组织的超微结构损害严重,而对肝脏及肺脏的影响较轻。提示米非司酮用于足月妊娠引产应慎重。

Effect of mifepristone on lymphocyte phenotypes and tissue trastructures of fetus

Objective: To evaluate the effect of mifepristone on lymphocyte phenotypes and tissue ultrastructures of fetus, and mifepristone'safety on fetus. Methods: Thirty healthy women with 22~24 weeks fetus were randomly divided into experimental group and control group. They were given 150 mg mifepristone per os 24 hours before labor induction in experimental group, no mifepristone in control group. Fetal peripheral blood lymphocyte phenotypes were analyzed by flowcytometry, the ultrastructures of fetuses, organs were observed by electron microscopy. Results: 1.The percentage of CD8+ , CD122+ cells and NK cells were all significantly lower in experimental group than those in control group (P<0.05); the ratio of CD4+/CD8+ was much higher in experimental group than that in control group, but no significant difference were shown between the experimental group and the control group in the percentage of CD3+, CD4+ and CD25+ (P>0.05). 2.In experimental group, the myocardial fibers, mitochondria were obviously changed, chromosomes coagulated; the foot cells of Bowan, scapsule in fetal kidney showed increscent nucleus, coagulated chromosomes and a vacuole -like appearance in mitochondria; more fat-storing cells were found in liver tissues; the glycogen particles and lipid droplets in pulmonary tissues were abundant in Clara cells. Conclusion: Mifepristone can affect the phenotypes of T-lymphocytes and NK cells of fetal blood, which result in immune response. Mifepristone may seriously damage myocardial tissues and renal tissues. Therefore, it is improper as a labor-inducing agent in women at term.