Mitra S C, Seshan S V, Salcedo J R, Gil J
Department of Obstetrics and Gynecology, St. Michael's Medical Center, Newark, New Jersey, USA.
Pediatr Nephrol. 2000 Apr;14(4):315-8. doi: 10.1007/s004670050766.
The purpose of the present study was to evaluate the pathological findings and perform morphometric analysis of the renal arteries of fetuses exposed to cocaine in utero. The control group consisted of 22 stillborn fetuses of unknown etiology whose mothers' urine was negative for cocaine or any other vasoactive substances. The study group comprised 29 stillborn fetuses whose mothers' urine was positive only for cocaine on the day of admission. Sections of fetal kidneys (4 microm), stained with hematoxylin and eosin and periodic acid-Schiff reagent, were examined under light microscopy (x40) to identify interlobular arteries. Morphometric analysis of these arteries was performed using a self-assembled system with a touch-sensitive screen as an interactive peripheral. Their inner and outer circumferences were measured by outlining them on the screen with a stylus. The radius (r) was calculated from the measurement of the circumference (2.pi.r). The difference of the radii of the outer and inner circumferences was the thickness of the arterial wall. The interlobular arterial thickness was significantly greater (P<0.001) in the cocaine-exposed group (mean 15.46+/-5.8 microm, 2SD) compared with the normal (mean 9.03+/-3.96 microm, 2SD). There was a significantly (P<0.001) positive relation with advancing gestational ages in both groups. The circumferences of the lumen of the arteries showed a significant (P<0.05) relation with advancing gestational ages in the normal group only. In the cocaine-exposed group, the arterial lumen circumference (mean 167.88+/-17.58 microm, 2SD) was significantly (P<0.001) smaller than in the normal group (mean 227.73+/-6.82 microm, 2SD). Thus, maternal cocaine abuse is associated with thickening of the interlobular arterial wall of the fetal kidney and narrowing of the lumen.
本研究的目的是评估子宫内暴露于可卡因的胎儿肾动脉的病理表现并进行形态计量分析。对照组由22例病因不明的死产胎儿组成，其母亲尿液中可卡因或任何其他血管活性物质检测呈阴性。研究组由29例死产胎儿组成，其母亲入院当天尿液中仅可卡因检测呈阳性。用苏木精-伊红和过碘酸-希夫试剂对胎儿肾脏切片（4微米）进行染色，在光学显微镜（×40）下检查以识别小叶间动脉。使用带有触摸屏作为交互式外围设备的自组装系统对这些动脉进行形态计量分析。用触笔在屏幕上勾勒出动脉轮廓来测量其内外周长。半径（r）由周长测量值（2πr）计算得出。外周和内周半径之差即为动脉壁厚度。与正常组（平均9.03±3.96微米，2标准差）相比，可卡因暴露组的小叶间动脉壁厚度显著更大（P<0.001）（平均15.46±5.8微米，2标准差）。两组中，小叶间动脉壁厚度均与孕龄增加呈显著（P<0.001）正相关。仅在正常组中，动脉管腔周长与孕龄增加呈显著（P<0.05）相关。在可卡因暴露组中，动脉管腔周长（平均167.88±17.58微米，2标准差）显著（P<0.001）小于正常组（平均227.73±6.82微米，2标准差）。因此，母亲滥用可卡因与胎儿肾小叶间动脉壁增厚和管腔狭窄有关。
