Starzyk K A, Salafia C M, Pezzullo J C, Lage J M, Parkash V, Vercruysse L, Hanssens M, Pijnenborg R
Department of Pathology, Georgetown University Medical Center, Washington, DC 20007-2197, USA.
Hum Pathol. 1997 Mar;28(3):353-8. doi: 10.1016/s0046-8177(97)90135-0.
The purpose of this study was to quantitatively analyze normal and preeclamptic uteroplacental vasculature. Myometrial arteries from eight placental bed biopsies from uncomplicated term deliveries and 12 from proteinuric preeclampsia were characterized as uteroplacental, spiral, or basal arteries. Basal lumens within 0.2 mm radius and spiral/uteroplacental lumens within 0.4 mm radius were considered as the same artery. The biopsy area, lumen density, and arterial density (after correction for multiple lumens), lumen area, lumen perimeter, mean wall thickness, inflated diameter, and a slant factor, measuring the obliqueness of arterial transection, and ratios of lumen characteristics to mean wall thickness were analyzed. In preeclamptic cases, there were more basal lumens/mm2 and basal arteries/mm2 (P=.003, P=.03), and more spiral lumens/mm2 and spiral arteries/mm2 (P = .01, P = .03). Basal lumen area (P = .0003) and wall thickness (P = .007), and basal and spiral artery lumen perimeters and inflated diameters (for each, P = .0001, P = .048, respectively) and inflated diameter/wall ratios (P = .04, P = .05) were reduced compared with normal cases. Preeclamptic spiral and basal arteries are more tortuous or densely distributed than normal placental bed arteries, with smaller-caliber lumens and thicker walls. Failure of proper placentation may result in abnormal spatial anatomy in the placental bed. Alternatively, an anatomic variant of spiral and basal arteries may be more susceptible to hemodynamic stresses and endothelial damage and may predispose to preeclampsia.
本研究的目的是对正常和子痫前期的子宫胎盘血管系统进行定量分析。选取8例足月顺产无并发症产妇胎盘床活检的子宫肌层动脉以及12例蛋白尿性子痫前期产妇的子宫肌层动脉，将其分为子宫胎盘动脉、螺旋动脉或基底动脉。半径0.2mm以内的基底管腔和半径0.4mm以内的螺旋/子宫胎盘管腔被视为同一动脉。分析活检面积、管腔密度和动脉密度（校正多个管腔后）、管腔面积、管腔周长、平均壁厚度、膨胀直径、测量动脉横切倾斜度的倾斜因子，以及管腔特征与平均壁厚度的比值。子痫前期病例中，每平方毫米的基底管腔和基底动脉更多（P = 0.003，P = 0.03），每平方毫米的螺旋管腔和螺旋动脉也更多（P = 0.01，P = 0.03）。与正常病例相比，基底管腔面积（P = 0.0003）和壁厚度（P = 0.007），以及基底和螺旋动脉的管腔周长和膨胀直径（分别为P = 0.0001，P = 0.048）和膨胀直径/壁厚度比值（P = 0.04，P = 0.05）均减小。子痫前期的螺旋动脉和基底动脉比正常胎盘床动脉更弯曲或分布更密集，管腔口径更小且壁更厚。胎盘着床异常可能导致胎盘床空间解剖结构异常。或者，螺旋动脉和基底动脉的解剖变异可能更容易受到血流动力学压力和内皮损伤的影响，从而易患子痫前期。
