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目的研究凋亡调控蛋白Bcl-2和Bax在正常早孕与稽留流产绒毛组织结构中的表达及其意义,探讨稽留流产原因。方法选择本院就诊的稽留流产患者和早孕人工流产患者各60例,分为A组、B组。流产后立即留取胚胎绒毛组织送病理。分别应用光镜观察各组绒毛组织细胞形态结构的改变;同时应用免疫组织化学方法和计算机图文分析系统检测Bax、Bcl-2在各组绒毛的表达及细胞凋亡情况。结果稽留流产组绒毛滋养细胞中凋亡指数为(33.32±0.79)%,明显高于对照组B组的(18.90±0.63)%,差异有统计学意义(P<0.01)。Bax和Bcl-2在两组合体滋养细胞中的阳性率比较显示,稽留流产组中Bax阳性率增高,Bcl-2阳性率下降,Bcl-2/Bax比值降低,差异均有统计学意义(P<0.01)。结论蜕膜绒毛中Bax阳性率增高和Bcl-2阳性率下降可使绒毛合体滋养细胞凋亡明显增加,并进一步导致稽留流产发生。
Objective To study the expression and significance of apoptosis regulatory proteins Bcl-2 and Bax in the tissue structure of normal early pregnancy and missed abortion, and to explore the causes of missed abortion. Methods Sixty patients with missed abortion and early abortion in our hospital were selected and divided into A group and B group. Immediately after abortion, the embryo villi tissue was taken for pathology. The morphological changes of villus cells in each group were observed by light microscope. Meanwhile, the expression of Bax and Bcl-2 in each group were detected by immunohistochemistry and computer graphic analysis system. Results The apoptotic index of trophoblastic cells in missed abortion group was (33.32 ± 0.79)%, which was significantly higher than that in control group B (18.90 ± 0.63)%, the difference was statistically significant (P <0.01). The positive rate of Bax and Bcl-2 in trophoblastic cells in two groups showed that the positive rates of Bax, Bcl-2 and Bcl-2 / Bax were lower in missed abortion group (P <0.01). Conclusions The increase of Bax positive rate and the decrease of Bcl-2 positive rate in decidua villus can significantly increase the apoptosis of villus syncytiotrophoblast and further lead to the missed abortion.