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目的:探讨米非司酮抗早孕的作用机理。方法:因非意愿妊娠要求终止妊娠的正常早孕妇女60例,分为3组,分别为常规负压吸宫对照组、负压吸引术前服用米非司酮100mg组和150mg,每组20例。运用RT-PCR及免疫组织化学方法检测各组绒毛组织中HOXA7、9、10mRNA和蛋白的表达。结果:①正常早孕绒毛组织在mRNA和蛋白水平均可见HOXA7、9、10基因的表达,表达主要在滋养细胞胞质,间质少量表达。②不同剂量的米非司酮均可以降低绒毛组织中HOXA7、9、10mRNA及蛋白的表达量,但对不同基因的降表达程度有所不同。150mg米非司酮对早孕绒毛组织中HOXA7、10基因的降表达作用明显大于100mg米非司酮(P<0.01)。服用不同剂量米非司酮后的早孕绒毛组织中HOXA7、9、10蛋白的表达位置仍以滋养细胞胞质为主,间质少量表达。结论:HOXA7、9、10基因表达于正常早孕绒毛组织中,服用米非司酮后可降低其表达,呈一定的剂量依赖性,但未改变蛋白的表达位置。米非司酮的抗早孕作用可能是通过对绒毛组织中HOXA7、9、10基因的调控来达到的,且以150mg的米非司酮作用明显。
Objective: To investigate the mechanism of anti-pregnancy effect of mifepristone. Methods: Sixty normal pregnant women who were asked to terminate pregnancy because of unwanted pregnancy were divided into three groups: control group with conventional negative pressure suction, negative control with 100 mg mifepristone and 150 mg with 20 cases in each group . RT-PCR and immunohistochemistry were used to detect the expression of HOXA7, 9, 10mRNA and protein in each group. Results: ① The expression of HOXA7, 9 and 10 genes in normal early villi tissues at mRNA and protein levels was mainly expressed in the cytoplasm and interstitium of trophoblast cells. ② The different doses of mifepristone can reduce the expression of HOXA7, 9, 10 mRNA and protein in villous tissue, but the expression level of different genes is different. The effect of 150 mg mifepristone on the down-expression of HOXA7 and 10 genes in chorionic villi in early pregnancy was significantly greater than that of 100 mg mifepristone (P <0.01). The expression of HOXA7,9,10 protein in the first trimester villi after taking mifepristone was still mainly expressed in the cytoplasm of trophoblast cells with little expression of interstitial. Conclusion: HOXA7,9,10 gene expression in normal early pregnancy villi tissue, after taking mifepristone can reduce its expression in a dose-dependent manner, but did not change the protein expression. The anti-early pregnancy effect of mifepristone may be achieved through the regulation of HOXA7,9,10 gene in villous tissue, and the effect of mifepristone 150mg is obvious.