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[剖宫产术后子宫瘢痕愈合不良的未分化型结缔组织发育异常女性子宫肌层的临床形态学及分子遗传学特征]

[Clinico-morphological and molecular-genetic characteristic of the miometrium with failure of the uterine scar after the Cesarean section at women with undifferentiated forms of connective tissue dysplasia].

作者信息

Demura T A, Kogan E A, Donnikov A E, Kan N E, Kesova M I, Martynov A I, Bolotova O V, Sukhikh G T

出版信息

Arkh Patol. 2012 May-Jun;74(3):18-21.

PMID:22937574
Abstract

Connective tissue state, its strength, is actual problem especially in the moment of labor because the weakness of labor activity or accelerated labor can be in depending on its consistency and elasticity. In addition, connective tissue is very important in the involution of the uterus after labor or wounds healing. Clinico-morphological and molecular-genetic investigation of 90 patients with undifferentiated forms of connective tissue dysplasia (uCTD) has been done. Reparation of tissue at patients with uCTD had a number of peculiarities, such as fibromuscular scar formation by substitution mechanisms with the laminin deficiency in the basic capillar membrane and extracellular matrix, accumulation of III and IV types of collagen, low expression of VEGF in the stromal cell and polymorphism of the alpha estrogen receptor gene. This immunohistochemical changes correlated with focuses of connective tissue disorganization as mucoid swelling, fibrinoid changes and hyalinosis, as well pathology of the microvasculature, resulted in chronic ischemia of the tissue. The disorganization is connected with disturbed reparation as a result of the genetically determined polymorphism of alpha and beta estrogen receptors. uCTD in pregnant women is prognostically significant for selection of way of delivery.

摘要

结缔组织状态及其强度,尤其是在分娩时,是一个实际问题,因为分娩活动的虚弱或产程加速可能取决于其韧性和弹性。此外,结缔组织在产后子宫复旧或伤口愈合中非常重要。对90例未分化型结缔组织发育异常(uCTD)患者进行了临床形态学和分子遗传学研究。uCTD患者的组织修复有许多特点,如通过替代机制形成纤维肌性瘢痕,基底毛细血管膜和细胞外基质中缺乏层粘连蛋白,III型和IV型胶原积累,基质细胞中VEGF低表达以及α雌激素受体基因多态性。这种免疫组化变化与结缔组织紊乱灶如黏液样肿胀、纤维蛋白样改变和玻璃样变性相关,也与微血管病变相关,导致组织慢性缺血。这种紊乱与α和β雌激素受体的基因多态性导致的修复障碍有关。孕妇的uCTD对分娩方式的选择具有预后意义。

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