Milovanov A P, Matsionis A E, Makarenko Iu M
Arkh Patol. 2005 Jan-Feb;67(1):14-7.
There have been performed morphometric and immunohistochemical examinations of adenohypophysis of 15 females who died of massive post-partum hemorrhages. The revealed changes in the form of hypertrophy of the basophilic cells are the initial stages of Sheehan's syndrome developing as a result of long-term progression of hypopituitarism. Massive obstetric bleeding causes severe complications-posthemorrhagic shock, the pathogenetic mechanism of which includes necrosis of the cells in the anterior part of the hypophysis. Cause-effect relations were shown for the amount of the post-partum blood loss and the revealed pathomorphologic changes in the hypophysis. Hyperproduction of ACTH by the basophilic cells of the adenohypophysis revealed by immunohistochemical analysis is a compensatory mechanism under the conditions of acute adrenal insufficiency inherent in any shock including posthemorrhagic.
对15例死于产后大出血的女性垂体前叶进行了形态计量学和免疫组织化学检查。所发现的嗜碱性细胞肥大形式的变化是希恩综合征由于垂体功能减退长期进展而发展的初始阶段。大量产科出血会导致严重并发症——产后出血性休克,其发病机制包括垂体前部细胞坏死。研究表明了产后失血量与垂体所揭示的病理形态学变化之间的因果关系。免疫组织化学分析显示垂体前叶嗜碱性细胞促肾上腺皮质激素分泌过多是任何休克(包括出血性休克)所固有的急性肾上腺功能不全情况下的一种代偿机制。