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目的 研究不同临产状态子宫下段平滑肌层及胎盘组织诱导型一氧化氮合成酶 (iNOS)的定位与活性变化 ,探讨内源性一氧化氮 (NO)参与分娩发动的机制。方法 分别在临产前 (未临产、先兆临产 )、临产后 (潜伏期、活跃期 )四组的足月孕妇剖宫产术中 ,取子宫下段平滑肌及胎盘标本用免疫组化法定性、半定量分析iNOS的表达。结果 iNOS表达阳性细胞主要为子宫下段肌细胞、胎盘绒毛合体滋养细胞及残留的细胞滋养细胞、绒毛间质Hoffbauer细胞。子宫下段肌层及胎盘临产前组iNOS染色强度及范围明显低于临产后组 (P <0 0 0 1)。未临产与先兆临产组及潜伏期与活跃期组 ,差异无显著性 (P >0 0 5 )。子宫下段肌层与胎盘iNOS表达有一定相关性 ,rS=0 6 4 (P <0 0 1)。结论 子宫下段肌层iNOS临产时酶活性上升 ,NO水平增高 ,有利于子宫下段成熟 ,为分娩发动作好准备 ;胎盘iNOS临产时酶活性上升 ,从而改善临产后子宫 -胎盘血循环障碍 ,防止发生胎儿窘迫。
Objective To investigate the location and activity of inducible nitric oxide synthase (iNOS) in the uterine segment of the uterine segment and placenta in different labor conditions and to explore the mechanism of endogenous nitric oxide (NO) involved in labor onset. Methods In the cesarean section of full-term pregnant women before labor (non-labor, threatened labor) and after labor (latent period, active phase), the smooth muscle and placenta of the lower uterine segment were determined by immunohistochemistry and semi-quantitative analysis iNOS expression. Results The main iNOS positive cells were myofibroblasts, placental syncytiotrophoblast, residual cytotrophoblast and villous interstitial Hoffbauer cells. The intensity and extent of iNOS staining in the lower uterine muscle and placenta prenatal group were significantly lower than those in the postpartum group (P <0.01). There was no significant difference between non-labor and threatened labor group and latent and active group (P> 0.05). The lower uterine myometrium and placenta iNOS expression has a certain correlation, rS = 0 64 (P <0 01). Conclusion The iNOS in the lower uterine muscle during labor increased enzyme activity, NO increased, is conducive to mature lower uterine segment, to prepare for the onset of childbirth; placental iNOS enzyme activity increased during labor to improve postpartum uterine-placental circulation disorders to prevent the fetus Distress.