中外医疗
中外醫療
중외의료
CHINA FOREIGN MEDICAL TREATMENT
2014年
36期
5-7,10
,共4页
早发型%重度子痫前期%胎盘超微结构
早髮型%重度子癇前期%胎盤超微結構
조발형%중도자간전기%태반초미결구
Early-onset%Severe preeclampsia%Placental ultrastructure
目的：通过透视电镜定量分析早发型重度子痫前期(EOSP)患者胎盘超微结构的变化特点，探讨EOSP胎盘超微结构定量改变与围产儿不良结局的关系。方法选择2012年1月—2014年1月在该院产科住院分娩的EOSP患者24例为EOSP组，早产孕妇30例作为对照组，采用计量的方法测定两组胎盘超微结构的参数，血管合体膜（vasculo-syncytial membrane, VSM)的厚度、微绒毛的数量、合体滋养细胞(syncytiotrophoblasts, ST)基膜至毛细血管内皮细胞基底膜(BM)的厚度、ST内脂质空泡的数量、线粒体(Mitochondria, Mito)和内质网(endoplasmic reticulum, ER)的形态结构的变化，记录新生儿出生时Apgar评分、出生体重，分析各参数变化与围产儿不良结局的关系。结果①EOSP组胎盘VSM和BM厚度明显增加(P<0.01)，微绒毛数量减少(P<0.01)，差异有统计学意义，脂质空泡的数量增加；②EOSP组线粒体和内质网肿胀或者结构消失；③宫内生长受限(FGR)发病率增加，差异有统计学意义（P<0.01),新生儿窒息增加，差异有统计学意义（P<0.05)。结论 EOSP状态下，胎盘的超微结构受到损伤，可能影响胎盘的转运和合成功能，导致围产儿不良妊娠结局。
目的：通過透視電鏡定量分析早髮型重度子癇前期(EOSP)患者胎盤超微結構的變化特點，探討EOSP胎盤超微結構定量改變與圍產兒不良結跼的關繫。方法選擇2012年1月—2014年1月在該院產科住院分娩的EOSP患者24例為EOSP組，早產孕婦30例作為對照組，採用計量的方法測定兩組胎盤超微結構的參數，血管閤體膜（vasculo-syncytial membrane, VSM)的厚度、微絨毛的數量、閤體滋養細胞(syncytiotrophoblasts, ST)基膜至毛細血管內皮細胞基底膜(BM)的厚度、ST內脂質空泡的數量、線粒體(Mitochondria, Mito)和內質網(endoplasmic reticulum, ER)的形態結構的變化，記錄新生兒齣生時Apgar評分、齣生體重，分析各參數變化與圍產兒不良結跼的關繫。結果①EOSP組胎盤VSM和BM厚度明顯增加(P<0.01)，微絨毛數量減少(P<0.01)，差異有統計學意義，脂質空泡的數量增加；②EOSP組線粒體和內質網腫脹或者結構消失；③宮內生長受限(FGR)髮病率增加，差異有統計學意義（P<0.01),新生兒窒息增加，差異有統計學意義（P<0.05)。結論 EOSP狀態下，胎盤的超微結構受到損傷，可能影響胎盤的轉運和閤成功能，導緻圍產兒不良妊娠結跼。
목적：통과투시전경정량분석조발형중도자간전기(EOSP)환자태반초미결구적변화특점，탐토EOSP태반초미결구정량개변여위산인불량결국적관계。방법선택2012년1월—2014년1월재해원산과주원분면적EOSP환자24례위EOSP조，조산잉부30례작위대조조，채용계량적방법측정량조태반초미결구적삼수，혈관합체막（vasculo-syncytial membrane, VSM)적후도、미융모적수량、합체자양세포(syncytiotrophoblasts, ST)기막지모세혈관내피세포기저막(BM)적후도、ST내지질공포적수량、선립체(Mitochondria, Mito)화내질망(endoplasmic reticulum, ER)적형태결구적변화，기록신생인출생시Apgar평분、출생체중，분석각삼수변화여위산인불량결국적관계。결과①EOSP조태반VSM화BM후도명현증가(P<0.01)，미융모수량감소(P<0.01)，차이유통계학의의，지질공포적수량증가；②EOSP조선립체화내질망종창혹자결구소실；③궁내생장수한(FGR)발병솔증가，차이유통계학의의（P<0.01),신생인질식증가，차이유통계학의의（P<0.05)。결론 EOSP상태하，태반적초미결구수도손상，가능영향태반적전운화합성공능，도치위산인불량임신결국。
Objective To analyze the characteristics and changes of the ultrastructure of human placenta in early-onset severe preeclampsia (EOSP) quantitatively by transmission electron microscopy, and explore the relationship between the quantitative changes of placental ultrastructure in EOSP and adverse perinatal outcome. Methods 24 cases with EOSP were selected as the EOSP group, and 30 pregnant women with premature birth were selected as the control group. A quantitative method was used to measure the two groupsˊparameters of placental ultrastructure, the thickness of vasculo-syncytial membrane (VSM), the number of microvilli, the thickness from the basement layer of syncytiotrophoblast (ST) to the basement membrane(BM) of capillary endothe-lial cell, the number of lipid vacuoles in ST, the changes in morphological structure of mitochondria (Mito) and endoplasmic reticu-lum(ER). The neonatal Apgar score and birth weight of the two groups were recorded, and the relationship between variation of various parameters and adverse perinatal outcome was analyzed. Results①In EOSP group, the placental VSM and BM significant-ly thickened(P<0.01), the number of microvilli decreased (P<0.01) and lipid vacuoles increased.②The mitochondria and endoplas-mic reticulum in EOSP group were swollen or the structure disappeared. ③In EOSP group, the incidence of fetal growth retarda-tion(FGR) was higher, the difference was statistically significant(P<0.01); the incidence of neonatal asphyxia was higher, the differ-ence was statistically significant(P<0.05). Conclusion When EOSP happens, the placental ultrastructure is damaged, which may af-fect the placental synthesization and transportation function and lead to the adverse perinatal outcome.
