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目的通过对树突状细胞(DCs)表面标志物CD1a、CD83和子宫内膜自然杀伤细胞(u NK细胞)表面标志物CD56在药物流产后异常子宫出血组织中表达状况的研究,探讨其在药物流产后异常子宫出血中的作用。方法选取2012年9月~2013年9月在该院妇产科自愿以药物流产方式终止妊娠的早孕妇女800例为研究对象,从中选取药物流产不全者30例为药物流产不全组,药物流产完全者35例为药物流产完全组,并选取同期在该院自愿行人工负压吸引流产术的35例患者作为对照组。收集3组蜕膜组织应用免疫组化法检测u NK细胞和不同分化阶段DCs的分布、形态及数量。应用Western blotting法分别检测CD56、CD1a及CD83的蛋白表达情况。结果免疫组化染色结果,3组u NK细胞和DCs均分布于腺体间与血管间;3组u NK细胞呈圆形或椭圆形;CD1a+im DCs呈圆形或卵圆形;CD83+m DCs形态均不规则,有多个突起,呈分枝状。Western blotting方法检测结果,对照组CD56蛋白的表达水平较药物流产组低,差异有统计学意义(P<0.01),且药物流产完全组CD56蛋白的表达水平较药物流产不全组低,差异有统计学意义(P<0.01);对照组CD1a蛋白的表达水平较药物流产组高,差异有统计学意义(P<0.01),且药物流产不全组CD1a蛋白的表达水平较药物流产完全组高,差异有统计学意义(P<0.01);对照组CD83蛋白的表达水平较药物流产完全组低,差异有统计学意义(P<0.01),且药物流产不全组CD83蛋白的表达水平较药物流产完全组低,差异有统计学意义(P<0.01)。结论 DCs和u NK细胞与药物流产后异常子宫出血的发生发展密切相关。
OBJECTIVE: To investigate the expression of CD56a, CD18a, a surface marker of dendritic cells (DCs), and CD56, a surface marker of uterine natural killer cells, in patients with abnormal uterine bleeding after medical abortion. The role of abnormal uterine bleeding after abortion. Methods From September 2012 to September 2013 in our hospital obstetrics and gynecology obstetrics and gynecology, abortion termination of pregnancy by way of pregnant women, 800 cases were selected as the research object, select 30 cases of incomplete medical abortion as medical abortion group, complete medical abortion 35 cases of complete abortion group and select the same period in the hospital voluntarily artificial suction abortion 35 patients as a control group. Collect three groups of decidua tissue immunohistochemical detection of u NK cells and different stages of differentiation DCs distribution, morphology and quantity. The protein expression of CD56, CD1a and CD83 were detected by Western blotting. Results The results of immunohistochemical staining showed that all three NK cell lines and DCs were located between the glandular and the vascular. The three groups of NK cells were round or oval, CD1a + im DCs were round or oval, CD83 + m DCs are irregular in shape, with multiple protrusions, branched. The result of Western blotting showed that the expression level of CD56 protein in control group was lower than that in medical abortion group (P <0.01), and the expression of CD56 protein in complete abortion group was lower than that in incomplete abortion group (P <0.01). The expression level of CD1a protein in control group was higher than that in medical abortion group (P <0.01), and the expression level of CD1a protein in incomplete abortion group was higher than that in complete abortion group (P <0.01). The expression level of CD83 protein in control group was lower than that in complete abortion group (P <0.01), and the expression level of CD83 protein in incomplete abortion group was significantly higher than that in complete abortion group Low, the difference was statistically significant (P <0.01). Conclusion DCs and u-NK cells are closely related to the occurrence and development of abnormal uterine bleeding after medical abortion.