Khong T Y, Tee J H, Kelly A J
Department of Pathology, Women's and Children's Hospital, North Adelaide, Australia.
Gynecol Obstet Invest. 1997;43(2):89-93. doi: 10.1159/000291828.
The spiral arteries of the human uterus are considerably remodeled structurally during pregnancy to facilitate an increase in blood flow. An immunohistochemical study was undertaken to determine whether the spiral arteries were innervated and, if so, whether they were denervated in the process of the physiologic vascular changes of normal pregnancy or, conversely, remained innervated in the absence of physiologic changes in abnormal pregnancy. Uterine tissues from nonpregnant nulliparous women, from normal early pregnancy, from normal late pregnancy, from abnormal early pregnancy (i.e. spontaneous abortions), and from abnormal late pregnancy (i.e. preeclampsia and intrauterine growth retardation) were subjected to immunohistochemistry using a panel of neuron-associated antibodies (neurofilament, neuron-specific enolase, S100 protein, protein gene product 9.5). All sections of the nonpregnant uterus showed an abundance of nerves deep in the myometrium, some of which were associated with radial and arcuate arteries. Very few nerves were demonstrated at the endomyometrial junction and no nerves were seen accompanying the intramyometrial spiral arteries. In both normal and abnormal pregnancy, nerves were not detected in the decidua or accompanying intradecidual spiral arteries, whether they were physiologically altered or not. Nerves were seen in the myometrium in 7 of 10 normal and in 1 of the 8 third-trimester abnormal placental beds, but none were seen accompanying intramyometrial spiral arteries, whether showing physiological changes or not. The lack of innervation of the spiral arteries in the nonpregnant state as well as in normal and abnormal pregnancy suggests that nonneurogenic mechanisms control blood flow at the spiral-arterial level.
在怀孕期间，人类子宫的螺旋动脉会发生显著的结构重塑，以促进血流量增加。本研究采用免疫组织化学方法，以确定螺旋动脉是否受神经支配，以及在正常妊娠的生理性血管变化过程中是否去神经支配，或者相反，在异常妊娠缺乏生理性变化的情况下是否仍受神经支配。对未孕未产女性、正常早孕、正常晚孕、异常早孕（即自然流产）和异常晚孕（即子痫前期和胎儿宫内生长受限）的子宫组织，使用一组神经元相关抗体（神经丝、神经元特异性烯醇化酶、S100蛋白、蛋白基因产物9.5）进行免疫组织化学检测。未孕子宫的所有切片显示，肌层深处有大量神经，其中一些与桡动脉和弓形动脉相关。在子宫内膜肌层交界处仅见极少神经，未见伴行于肌层内螺旋动脉的神经。在正常和异常妊娠中，无论蜕膜是否发生生理性改变，在蜕膜或伴行于蜕膜内螺旋动脉中均未检测到神经。在10例正常妊娠中的7例以及8例孕晚期异常胎盘床中的1例的肌层中可见神经，但无论是否显示出生理性变化，均未见伴行于肌层内螺旋动脉的神经。未孕状态以及正常和异常妊娠时螺旋动脉均缺乏神经支配，这表明在螺旋动脉水平，非神经源性机制控制着血流。
