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目的研究妊娠高血压综合征(妊高征)患者胎儿不同段脐静脉中膜及其平滑肌形态的改变情况,探讨妊高征和脐静脉中膜平滑肌的关系。方法收集胎儿脐带36条,其中正常孕妇17例,妊高征患者19例(轻度子痫前期患者9例,重度子痫前期患者6例,子痫患者4例),取不同段(胎盘端,中间段,胎儿端)的脐带组织进行常规脱水、包埋、切片及染色。采用数码显微镜进行显微摄像,计算机图像分析软件测试不同段脐静脉的中膜厚度、平滑肌面积、平滑肌细胞核的数密度和面密度,并对测试结果进行分析比较。结果从胎盘端到胎儿端,脐静脉中膜厚度逐渐减小(P<0.05),而平滑肌面积、平滑肌细胞核面密度和数密度的差异没有统计学意义(P>0.05)。与正常孕妇相比,妊高征患者胎儿的脐静脉中膜厚度、平滑肌细胞核面密度和数密度明显增大,并随病情严重程度逐步加剧(P<0.05);而中膜平滑肌面积的差异没有统计学意义(P>0.05)。结论妊高征患者胎儿脐静脉平滑肌增殖导致中膜明显增厚,其原因可能是对高血压的一种适应性代偿反应。
Objective To study the morphological changes of the umbilical vein medulla and its smooth muscle in different stages of pregnancy in patients with pregnancy induced hypertension (PIH) and to explore the relationship between PIH and umbilical venous smooth muscle. Methods Thirty-six umbilical cord fetuses were collected, of which 17 were normal pregnant women, 19 were PIHs, 9 were mild preeclampsia, 6 were severe preeclampsia and 4 were eclampsia. , The middle section, fetal side) umbilical cord tissue for routine dehydration, embedding, sectioning and staining. The microscopic images were taken with a digital microscope. The thickness, smooth muscle area, number density and surface density of smooth muscle nuclei in different sections of umbilical vein were measured by computer image analysis software. The test results were analyzed and compared. Results From the placenta to the fetal end, the thickness of the umbilical vein gradually decreased (P <0.05), but there was no significant difference between the smooth muscle area, smooth muscle cell nuclear density and density (P> 0.05). Compared with normal pregnant women, the umbilical vein intima-media thickness, smooth muscle cell nucleus density and number density of fetus with PIH were significantly increased and gradually increased with the severity of the disease (P <0.05), while there was no difference in smooth muscle area Statistical significance (P> 0.05). Conclusion Proliferation of fetal umbilical vein smooth muscle in patients with PIH leads to significant thickening of the intima, which may be an adaptive compensatory response to hypertension.