Borzenko I, Konkov D, Kondratova I, Basilayshvili O, Gargin V
1Kharkiv National Medical University; 2Kharkiv Regional Clinical Perinatal Center, Ukraine.
3National Pirogov Memorial Medical University, Vinnytsya, Ukraine.
Georgian Med News. 2019 Nov(296):131-134.
Recently, worldwide authors have paid particular attention to vascular endothelium in the mother-placenta-fetus system for the understanding of development of vascular network and its normal functioning, possible gestational endotheliopathy. Endothelial dysfunction is important in the development of thrombosis, neoangiogenesis and vascular remodeling, being the key to the development of obstetric and perinatal disorders. The aim of the study was to reveal morphological signs of endotheliopathy in spiral arteries in preeclampsia, which is important for understanding the development of pregnancy complications. Placentas were obtained after delivery from mothers with preeclampsia served as the material for morphological study. A comparison group included cases from women with a physiological course of pregnancy. The morphological structure was studied after proceeding of slides stained with hematoxylin and eosin, and according to van Gieson. Morphometry was used to determine the specific vascular density, specific density of connective tissue, thickness of the walls of the spiral arteries, cross sectional area of spiral arteries, endotheliocyte height, the diameter of the nuclei of endothelial cells, nuclear cytoplasmic relationships in endotheliocytes, relative volume of injured endothelial cells. As results, it was detected, that development of preeclampsia is associated with signs of remodelling of the spiral arteries. Placental spiral arteries in preeclampsia are characterized by a decrease of specific vascular density by 36,49% with a simultaneous increase of specific density of connective tissue by 43,60%, which is accompanied by thickening of the walls of the spiral arteries 2,82 times and reducing of cross sectional area of spiral arteries 1,57 times. The spiral arteries are also found to have proliferation of the endothelium, hypertrophy of the muscular layer, marked enlargement of the perivascular connective tissue with the formation of the so-called fibrous cuff, resulting in the narrowing of the lumen of the vessels, up to their obliteration. Gestational endotheliopathy is characterized by a decrease in the height of endotheliocytes from 6.19±0.07 x10-6 m to 4.78±0.06 x10-6 m, a decrease in the diameter of cells from 3.25±0.02 x10-6 m to 2.97±0.04 x10-6 m, an increase in the relative volume of damaged endotheliocytes from 6.16±0.23% to 47.07 ±3.61%.
最近，世界各地的作者特别关注母-胎盘-胎儿系统中的血管内皮，以了解血管网络的发育及其正常功能，以及可能的妊娠期内皮病变。内皮功能障碍在血栓形成、新生血管生成和血管重塑中起重要作用，是产科和围产期疾病发展的关键。本研究的目的是揭示子痫前期螺旋动脉内皮病变的形态学特征，这对于理解妊娠并发症的发生发展具有重要意义。研究材料取自子痫前期产妇分娩后的胎盘，作为形态学研究的材料。对照组包括妊娠生理过程的产妇病例。用苏木精-伊红染色和范吉森染色法对切片进行处理后，研究其形态结构。采用形态计量学方法测定血管比密度、结缔组织比密度、螺旋动脉壁厚度、螺旋动脉横截面积、内皮细胞高度、内皮细胞核直径、内皮细胞的核质关系、受损内皮细胞的相对体积。结果发现，子痫前期的发生与螺旋动脉重塑的迹象有关。子痫前期胎盘螺旋动脉的特征是血管比密度降低36.49%，同时结缔组织比密度增加43.60%，伴有螺旋动脉壁增厚2.82倍，螺旋动脉横截面积减小1.57倍。还发现螺旋动脉存在内皮细胞增生、肌层肥大、血管周围结缔组织明显增生形成所谓的纤维袖套，导致血管腔狭窄，直至闭塞。妊娠期内皮病变的特征是内皮细胞高度从6.19±0.07×10⁻⁶m降至4.78±0.06×10⁻⁶m，细胞直径从3.25±0.02×10⁻⁶m降至2.97±0.04×10⁻⁶m，受损内皮细胞的相对体积从6.16±0.23%增至47.07±3.61%。
