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妊娠高血压综合征合并胎儿宫内生长迟缓患者胎盘病理变化与血管细胞黏附分子-1表达的关系

[Relationship between pathological changes and the expression of vascular cell adhesion molecule-1 in the placenta of patients with pregnancy-induced hypertension complicated by intrauterine growth retardation].

作者信息

Wang Zhi-Jian, Yu Yan-Hong, Shen Li-Yong

机构信息

Department of Obstetrics and Gynecology, Nanfang Hospital, First Military Medical University, Guangzhou 510515, China.

出版信息

Di Yi Jun Yi Da Xue Xue Bao. 2002 Nov;22(11):1022-4.

Abstract

OBJECTIVE

To study the relationship of the pathological changes with the expression of vascular cell adhesion molecule-1(VCAM-1) in the placenta of patients with pregnancy-induced hypertension (PIH) that is complicated by intrauterine growth retardation (IUGR).

METHODS

Tissue specimens of the placenta were respectively collected from 30 patients with PIH complicated by IUGR, 28 patients with IUGR, 25 patients with PIH and 30 normal women after delivery. After HE and PAS staining, the tissue sections were observed microscopically to detect morphological changes in the placenta. Immunohistochemical examination was employed to detect the expression of the VCAM-1 in the decidual vascular endothelium, syncytiotrophoblast and villous capillary vessel of the placenta in these tissue specimens.

RESULTS

Significant pathological changes were observed in 22 placentas of the patients with PIH complicated by IUGR, with the incidence of 73.33 %. The pathological changes exemplified by stromal fibrosis, fibrinoid necrosis and leucocyte infiltration of the villi, increase in villous syncytial nodules, decrease in villous vascular tissues, hyperplasia of cytotrophoblasts and basal lamina thickening were more prevalent in the placentas of patients with PIH complicated by IUGR than in normal women (P<0.05). The expression of VCAM-1 in the decidual vascular endothelium and placental villous capillary vessels was observed to be significantly higher in the placentas with pathological changes than in those without (P<0.05), which was the opposite to the changes in the expression in the syncytiotrophoblast (P<0.05).

CONCLUSION

Significant pathological changes can be present in the placenta of patients with PIH complicated by IUGR, and may be intimately related to abnormal expressions of VCAM-1 in the placenta.

摘要

目的

研究妊娠高血压综合征(PIH)合并胎儿宫内生长受限(IUGR)患者胎盘的病理变化与血管细胞黏附分子-1(VCAM-1)表达的关系。

方法

分别采集30例PIH合并IUGR患者、28例IUGR患者、25例PIH患者及30例正常产妇产后的胎盘组织标本。经HE和PAS染色后,显微镜下观察组织切片,检测胎盘的形态学变化。采用免疫组织化学方法检测这些组织标本中胎盘蜕膜血管内皮、合体滋养层及绒毛毛细血管中VCAM-1的表达。

结果

PIH合并IUGR患者的22例胎盘出现明显病理变化,发生率为73.33%。PIH合并IUGR患者胎盘的病理变化,如绒毛间质纤维化、纤维素样坏死及白细胞浸润、绒毛合体结节增多、绒毛血管组织减少、细胞滋养层增生及基膜增厚等,比正常产妇更为普遍(P<0.05)。有病理变化的胎盘蜕膜血管内皮及胎盘绒毛毛细血管中VCAM-1的表达明显高于无病理变化者(P<0.05),与合体滋养层中的表达变化相反(P<0.05)。

结论

PIH合并IUGR患者的胎盘可出现明显病理变化,且可能与胎盘中VCAM-1的异常表达密切相关。

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