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目的探讨GDM时胎盘滋养细胞存在SHBG及其变化与GDM发病机制的关系。方法应用免疫细胞化学染色以及包埋前免疫电镜技术,检测GDM胎盘组织中SHBG的表达和观察SHBG在GDM胎盘组织细胞内的分布特征。结果电镜下GDM组胎盘合体滋养细胞表面微绒毛排列紊乱、肿胀、数目减少,绒毛间隙变窄、断裂。胞质内粗面内质网扩张,线粒体肿胀,细胞核形状不规则,染色质分布异常,未见高电子密度的颗粒。光镜下GDM组免疫阳性染色分布于整个胎盘合体滋养细胞,主要位于细胞膜和细胞浆,但是微绒毛侧和基底膜侧着色都不甚均匀,表达弱。GDM组胎盘SHBG免疫染色阳性表达率(25/30,83.3%)较对照组胎盘SHBG免疫染色阳性表达率(28/30,93.3%)减低(P<0.01)。结论 GDM时胎盘滋养细胞存在着SHBG,但其合成和分泌减少,在GDM发病过程中的发挥着重要作用。
Objective To investigate the relationship between the presence of SHBG in placental trophoblast cells and the pathogenesis of GDM during GDM. Methods The expression of SHBG in GDM placenta was detected by immunocytochemistry and immunohistochemistry before embedding. The distribution of SHBG in GDM placenta was observed. Results Under the electron microscope, the placental syncytiotrophoblasts in the GDM group were disordered on the surface of microvilli, swollen, and the number decreased, the villus space narrowed and ruptured. Cytoplasmic rough endoplasmic reticulum expansion, mitochondria swelling, irregular nuclear shape, abnormal distribution of chromatin, no high electron density particles. Immunohistochemical staining of GDM group was found in the whole placenta syncytiotrophoblast, mainly located in the cell membrane and cytoplasm, but the microvilli side and basement membrane side were not evenly colored, the expression was weak. The positive rate of SHBG immunostaining of placenta in GDM group (25/30, 83.3%) was lower than that in control group (28/30, 93.3%) (P <0.01). Conclusion There is SHBG in placental trophoblast cells during GDM, but the synthesis and secretion of SHBG decrease, which play an important role in the pathogenesis of GDM.