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目的:检测人胎盘组织中糖皮质激素受体水平,探讨其与妊娠子宫收缩的关系。方法:收集2010年1～8月在遵义医学院附属医院产科住院的60例单胎、足月妊娠、初产妇为研究对象,根据宫缩情况分为3组,每组各20例。取产后胎盘母体面(脐带附着处)约2 cm×2 cm×1 cm组织,标本经处理后采用免疫组化Envision法检测胎盘中糖皮质激素受体表达水平,并进行图像分析。结果:①免疫组化结果显示:宫缩正常组人胎盘滋养叶细胞胞浆中糖皮质激素受体强阳性表达,为黄色或棕黄色染色,原发性宫缩乏力组与无宫缩组人胎盘滋养叶细胞胞浆透明,糖皮质激素受体几乎无表达。②宫缩正常组人糖皮质激素受体阳性颗粒平均光密度值为0.335±0.119,宫缩乏力组为0.185±0.074,无宫缩组为0.182±0.077,3组值两两比较,宫缩正常组比原发性宫缩乏力组及无宫缩组高,P<0.05,差异有统计学意义,原发性宫缩乏力组与无宫缩组比较,P>0.05,差异无统计学意义。③宫缩正常组20例,糖皮质激素受体阳性表达16例,阳性表达率为80.0%;原发性宫缩乏力组中阳性表达2例,阳性表达率为10.0%;无宫缩组阳性表达1例,阳性表达率为5.0%,宫缩正常组与原发性宫缩乏力组及无宫缩组比较,P<0.05,差异均有统计学意义,卡方值分别为χ2=19.798,χ2=23.018,原发性宫缩乏力组与无宫缩组比较,P>0.05,差异无统计学意义。结论:糖皮质激素受体在人胎盘中的表达水平与宫缩强度有密切关系,可能与早产及产力异常的发生有关。
Objective: To detect the level of glucocorticoid receptor in human placenta tissue and to explore its relationship with uterine contractions in pregnancy. Methods: From January to August 2010, 60 singleton and term pregnant women and primipara inpatients in obstetrics and gynecology hospital of Affiliated Hospital of Zunyi Medical College were enrolled in this study. The patients were divided into 3 groups with 20 cases in each group. Placenta maternal surface (umbilical cord attached) about 2 cm × 2 cm × 1 cm tissue was taken from postpartum. The placental expression of glucocorticoid receptor was detected by immunohistochemical Envision method and the image analysis was performed. Results: ① Immunohistochemical results showed that the expression of glucocorticoid receptor in the cytoplasm of human placental trophoblast cells in the normal contractions was strongly positive, yellow or brown staining, with primary uterine atresia and without contractions Placental trophoblast cells cytoplasm transparent, glucocorticoid receptor almost no expression. (2) The average optical density of human glucocorticoid receptor-positive particles in normal group was 0.335 ± 0.119, that of uterine atresia group was 0.185 ± 0.074, and that of non-contractions group was 0.182 ± 0.077 Group than in primary uterine atresia group and without uterine contractions group, P <0.05, the difference was statistically significant, the primary uterine atresia group and no contractions group, P> 0.05, the difference was not statistically significant. (3) 20 cases of contractions normal group, 16 cases of glucocorticoid receptor positive expression, the positive rate was 80.0%; primary uterine atresia group positive expression in 2 cases, the positive rate was 10.0%; no contractions group positive (P <0.05), the difference was statistically significant, the chi square values were χ2 = 19.798, respectively. There was no significant difference between the normal uterine contractions group and the normal uterine contractions group (P <0.05) χ2 = 23.018, primary uterine atresia group and no contractions group, P> 0.05, the difference was not statistically significant. Conclusion: The expression level of glucocorticoid receptor in human placenta is closely related to the intensity of uterine contractions, which may be related to the occurrence of premature labor and the abnormal production of labor force.