电邮这篇文章 对早期妊娠流产胎儿进行全面分子形态学研究的结果
- 作者: Romanova O.A.1, Pechenikova V.A.1
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隶属关系:
- North-Western State Medical University named after I.I. Mechnikov
- 期: 卷 71, 编号 1 (2022)
- 页面: 79-90
- 栏目: Original Research
- URL: https://journals.rcsi.science/jowd/article/view/82972
- DOI: https://doi.org/10.17816/JOWD82972
- ID: 82972
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详细
论证。胎儿停育导致早期妊娠孕囊排出的主要原因。在本病的病因中，遗传原因是最主要原因。目前，免疫方面的母体-胎儿系统广泛讨论。在这方面，根据绒毛膜的核型，以及孕囊排出后，研究胎儿停育期间母体和胎儿之间的免疫关系的特征是一项紧迫的问题。这可以优化胎儿停育患者的筛查，并确定导致习惯性流产的因素。
本研究的目的是根据绒毛膜染色体异常的存在和患者孕囊排出史，研究胎儿停育中流产胎儿的形态学和免疫组化特征。
材料与方法。对273例胎儿停育的流产胎儿进行了全面的形态学和免疫组织化学研究（CD56、 HLA-DR-II）。第一组包括有不同变异的绒毛膜染色体异常的病人（n=169），第二组包括正常绒毛膜核型的病人（n=104）。根据孕囊排出的存在，考虑到患者的病史，并对数据进行了分析。
结果。该研究揭示了绒毛膜染色体异常的胎儿停育中流产胎儿的形态特征：绒毛明显水肿、增厚、坏死，更严重的炎症变化为蜕膜组织和子宫内膜的中度至重度淋巴细胞和巨噬细胞浸润，其中白细胞按微脓肿类型积聚。已证明，流产胎儿中炎症变化的严重程度仅受绒毛膜核型的影响，不受无活胚卵在宫腔内存留时间的影响，也不受患者病历中出现孕囊排出的影响。研究表明，流产胎儿中的CD56和HLA-DR II类水平取决于患者孕囊排出的病史，而与绒毛膜核型无关。
结论。因此，对于没有妇科疾病的患者，在初次胎儿停育时，只需要采用绒毛膜核型来确定胎儿停育的原因；而对重复胎儿停育进行CD56和HLA-DR II类标志物的免疫组化检测是有意义的。
作者简介
Olga A. Romanova
North-Western State Medical University named after I.I. Mechnikov
Email: romanova-roa@yandex.ru
ORCID iD: 0000-0003-2637-5620
SPIN 代码: 5740-7953
Researcher ID: ААВ-2136-2021
MD, obstetrician-gynecologist of the Department of Gynecology
俄罗斯联邦, 41, Kirochnaya St., Saint Petersburg, 191015Victoria A. Pechenikova
North-Western State Medical University named after I.I. Mechnikov
编辑信件的主要联系方式.
Email: p-vikka@mail.ru
SPIN 代码: 9603-5645
Researcher ID: ААВ-2105-2021
MD, Dr. Sci. (Med.), PhD, Professor of the Department of Obstetrics and Gynecology
俄罗斯联邦, 41, Kirochnaya St., Saint Petersburg, 191015参考
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图1 染色体异常的绒毛：合并明显的增厚和水肿， 滋养细胞坏死，绒毛间的纤维素坏死区。苏木精-伊红染色，增大×100倍
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图2 染色体绒毛膜异常的蜕膜组织（微脓肿）苏木精-伊红染色，增大×100倍
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图3 染色体绒毛膜异常中子宫内膜的微脓肿苏木精-伊红染色，增大×100倍
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图4 根据孕囊排出史，胎儿停育患者子宫内膜和蜕膜组织中CD56和HLA-DR类II的免疫组织化学研究
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图5 CD56免疫组织化学显微镜照片：a——在初次胎儿停育的病人的子宫内膜中；b——在初次胎儿停育的病人的蜕膜组织中；c——在一个有孕囊排出史病人的子宫内膜中；d——在一个有孕囊排出史病人的蜕膜组织中。免疫组织化学检查，增大×400陪
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图6 HLA-DR II级免疫组织化学显微镜照片：a——在初次胎儿停育的病人的子宫内膜中；b——在初次胎儿停育的病人的蜕膜组织中；c——在一个有孕囊排出史病人的子宫内膜中；d——在一个有孕囊排出史病人的蜕膜组织中。免疫组织化学检查，增大×400陪
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