摘要
目的：观察米非司酮对妊娠中期胎儿肾脏超微结构的影响。方法：将25例中期引产孕妇（孕龄16～28周）随机分为2组：对照组（水囊组，n=10）；实验组（米非司酮＋水囊组，n=15）。实验组按孕龄分为实验Ⅰ组（n=10，孕周16～22周），实验Ⅱ组（n=5，孕周23～28周），实验组口服米非司酮100mg·d^-1．连服3d，行水囊引产，对照组只行水囊引产。胎儿娩出后取肾脏组织，电镜下观察肾脏组织的超微结构。结果：实验Ⅰ组肾小球毛细血管内皮细胞肿胀、空化；系膜细胞核不规则，胞质内线粒体肿胀．系膜基质正常。滤过膜内皮细胞质厚，无孔，基底膜薄，多数足细胞核基质空化，足细胞轻度微绒毛化，次级突起可见较多微丝，突起呈融合状。近曲小管上皮细胞核空化，胞质内可见空泡结构及较多溶酶体。远曲小管大部分细胞核及胞质空化。实验Ⅱ组肾小球毛细血管可见内皮细胞孔，局部轻度增生呈连拱状，系膜细胞少量核不规则或轻度固缩状，胞质内线粒体轻度肿胀，部分嵴断裂。滤过膜内皮细胞胞质轻度肿胀，足突细胞结构基本正常，可见初级和次级突起，局部融合，轻度微绒毛化。近曲及远曲小管结构基本正常。结论：米非司酮可以引发胎儿肾脏的缺血缺氧性改变，孕龄越小者胎儿肾脏超微结构改变越明显。
Objective To observe the effect of mifepristone on ultrastructure of fetal kidney in the second trimester pregnancy. Methods Twenty five normal pregnant women whose pregnancy ranged from 16- 28 weeks were randomly divided into 2 groups： control group （n= 10） and test group （ n= 15 ）. The women in control group were given waterhag to induce labor alone. Test group was divided into 2 groups （test group Ⅰ ： n= 10, gestation of 16-22 weeks; test group Ⅱ： n=5, gestation of 23-28 weeks）. Test group took mifepristone 100 mg orally per day for 3 d, then were given waterbag to induce labor. After delivery of fetus, fetal kidney was separated immediately for observation by transmission electron microscopy. Results In test group Ⅰ , Glomerulus＇s cell was swelling and cavitation. Mesangial cell nuclei showed irregular shape and mitochondria swelled, stroma was normal. The thick endothelial cytoplasm, imperforation, thin basal membrane and podocyte matrix cavitation, villus-like podocyte, secondary enation, proximal convoluted tubule nuclei cavitation were found in filtration membrane, intracytoplasm was vacuoles and had lysosomes. Some nuclei and kytoplasm had cavitation in distal convoluted tubule. In test group Ⅱ , Glomerulus＇s cell cavitation was seen. Hyperplasia look like arch local. Little mesangial cell nuclei showed irregular shape or light pycnosis. Mitochondrion in cytoplasm was mild swelling, crest fragmentated partly. The cytoplasm showed mild swelling, podocytes were normal, primary and secondary enation, local fusion and mild villus were found in filtration membrane , proximal convoluted tubule and distal convoluted tubule were normal. Conclusion Mifepristone could take ischemia hypoxia changes in the ultrastructure of fetal kidney in the second trimester pregnancy. The earlier the stage of the fetus is, the more obvious the ultrastructural changes are.
出处
《吉林大学学报（医学版）》
CAS
CSCD
北大核心
2006年第5期854-857,共4页
Journal of Jilin University：Medicine Edition
基金
吉林省科技厅资助课题(20020644)
