Wakasa Tomoko, Wakasa Kenichi, Nakayama Masahiro, Kuwae Yuko, Matsuoka Keiko, Takeuchi Makoto, Suehara Noriyuki, Kimura Tadashi
Department of Diagnostic Pathology, Osaka City University Graduate School of Medicine, Osaka, Japan.
Gynecol Obstet Invest. 2009;67(2):137-44. doi: 10.1159/000172805. Epub 2008 Nov 13.
The histological changes in uterine blood vessels during pregnancy have been well investigated, but there have been few reports focusing on the changes in blood vessels during the involution process, especially within the first 24 h. We observed the process of uterine involution, focusing on the vessels of the resected uterus.
Paraffin-embedded uterine samples from 15 patients who underwent hysterectomy because of severe cervical laceration and uterine rupture were examined. The time between delivery and hysterectomy ranged from 15 min to 456 h. The specimens were stained with hematoxylin-eosin, elastica-van Gieson and an antioxytocin receptor antibody.
Changes in the uterine vessels varied substantially based on their location. The intima in arteries of the endometrial side thickened within 5 h after delivery. On the serosal side, phlebosclerosis was demonstrated 6 weeks postpartum. Immunoreactivity for the oxytocin receptor (OTR) appeared in the muscular medias of arteries 5 h after delivery although it was not expressed before this period.
Remodeling of uterine vessels involved thickening of the arterial intima and OTR expression in vessel walls during the first 5 h postpartum; the parameters normalized within 6 weeks. However, phlebosclerosis persisted for a long time on the serosal side.
孕期子宫血管的组织学变化已得到充分研究，但关注 involution 过程中血管变化的报道较少，尤其是产后最初24小时内的变化。我们观察了子宫 involution 过程，重点关注切除子宫的血管情况。
检查了15例因严重宫颈裂伤和子宫破裂而接受子宫切除术患者的石蜡包埋子宫样本。分娩至子宫切除的时间为15分钟至456小时。标本用苏木精 - 伊红、弹性蛋白 - 凡吉森染色及抗催产素受体抗体染色。
子宫血管的变化因位置不同而有很大差异。产后5小时内，子宫内膜侧动脉内膜增厚。在浆膜侧，产后6周出现静脉硬化。产后5小时，动脉肌层出现催产素受体（OTR）免疫反应性，在此之前未表达。
产后最初5小时内，子宫血管重塑包括动脉内膜增厚和血管壁OTR表达；这些参数在6周内恢复正常。然而，浆膜侧静脉硬化持续时间较长。
