Zhao A, Lin Q, Zhou H
Renji Hospital, Shanghai Second Medical University.
Zhonghua Fu Chan Ke Za Zhi. 1997 Nov;32(11):674-7.
To investigate the effects of uterine local immunological factors in recurrent spontaneous abortion (RSA).
The decidua vessels were studied by immunohistochemical ABC method in 26 cases of RSA and 10 cases of normal pregnant women (control group). Meanwhile, serum IgG, IgM, IgA, C3 and CH50 were determined in RSA group and in control group.
In RSA cases, the depositions of IgM (17 cases, 80.8%) were significantly increased (P < 0.001, respectively) as compared with the control group, the depositions of IgG (2 cases, 7.8%) were significantly decreased (P < 0.001); the levels of serum C3, CH50 were significantly decreased (P < 0.01 respectively), but the level of serum IgA was increased significantly (P < 0.05) as compared with the control group. The depositions of C3 were significantly increased in RSA who had autoantibodies (P < 0.01), as compared with those without autoantibodies. In addition, the positive stain of IGM and C3 in the cytoplasm and nuclei of decidua cells and in the cytoplasm of gland cells of some RSA patients were also observed.
The results suggest that the immunological damage of decidua vessels is a very important factor in immunopathogenesis for RSA. Decidua cells and gland cells may have potential immunological function.
探讨子宫局部免疫因素在复发性自然流产(RSA)中的作用。
采用免疫组织化学ABC法对26例RSA患者及10例正常孕妇(对照组)的蜕膜血管进行研究。同时,检测RSA组和对照组血清IgG、IgM、IgA、C3和CH50水平。
RSA患者中,IgM沉积(17例,80.8%)较对照组显著增加(P均<0.001),IgG沉积(2例,7.8%)显著减少(P<0.001);血清C3、CH50水平显著降低(P均<0.01),但血清IgA水平较对照组显著升高(P<0.05)。有自身抗体的RSA患者C3沉积较无自身抗体者显著增加(P<0.01)。此外,还观察到部分RSA患者蜕膜细胞胞质和胞核以及腺细胞胞质中IGM和C3阳性染色。
结果提示,蜕膜血管的免疫损伤是RSA免疫发病机制中的一个非常重要的因素。蜕膜细胞和腺细胞可能具有潜在的免疫功能。