摘要
目的：探讨子宫局部免疫反应在复发性流产发病机理中的作用。方法：采用免疫组织化学ＡＢＣ法，对２６例复发性流产患者（流产组）和１０例正常孕妇（对照组）的子宫蜕膜血管进行免疫病理观察，并测定血清免疫球蛋白和补体水平。结果：流产组蜕膜血管壁有免疫球蛋白ＩｇＭ和补体Ｃ３沉着，分别为１７例（６５．４％）和２１例（８０．８％），而对照组为阴性，两组比较，差异有显著性（Ｐ＜０．００１）；血管壁ＩｇＧ的沉着流产组为２例（７．８％），明显低于对照组８例（８０．０％，Ｐ＜０．００１）；血Ｃ３、ＣＨ５０水平，流产组明显低于对照组（Ｐ分别＜０．０１），而血ＩｇＡ水平流产组明显高于对照组（Ｐ＜０．０５）；自身抗体阳性患者Ｃ３沉着率明显高于自身抗体阴性者（Ｐ＜０．０１）。流产组患者蜕膜细胞浆、细胞核及蜕膜腺上皮细胞浆内见有ＩｇＭ及Ｃ３沉着。结论：子宫蜕膜血管免疫损伤是导致复发性流产的重要因素。
Objective: To investigate the effects of uterine local immunological factors in recurrent spontaneous abortion (RSA). Methods: 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. Results: In RSA cases, the depositions of IgM(17 cases, 65.4%) and C3 (21 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 in some RSA patients were also observed. Conclusions: The results suggest that the immunological damage of decidua vessels is a very important factor in immunopathogenesis for RSA. Decidua cells and glang cells may have potential immunological function.
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
1997年第11期674-677,I042,共5页
Chinese Journal of Obstetrics and Gynecology
基金
国家自然科学基金
