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目的研究血管生成素1(Ang-1)和血管生成素2(Ang-2)在药物流产后异常子宫出血者子宫内膜组织中的表达,探讨其与异常子宫出血的关系。方法1087例早孕药物流产后异常出血者的宫腔刮出物行病理学检查;选取40例异常出血者,以20例药物流产后无异常出血者作对照,应用免疫组织化学方法检测两组子宫内膜组织中Ang-1、Ang-2的阳性表达率和表达强度的差异。结果1.1087例中有绒毛和蜕膜残留者占80.5%;2.Ang-1、Ang-2蛋白在药物流产后的子宫内膜组织的腺上皮及内膜基质细胞和血管壁中均有表达,以在腺体表达为主;3.两组Ang-1、Ang-2表达率均为100%,但异常出血组Ang-1、Ang-2的表达强度均较对照组高,差异有显著性(P<0.01)。结论药物流产后绒毛和蜕膜的残留可能是导致出血时间延长和出血量多的主要原因;药物流产后异常子宫出血者子宫内膜中血管生成素的表达增强,可能引起血管生成的异常,从而使绒毛和蜕膜不容易脱落或子宫内膜的修复受影响,导致了出血时间的延长。
Objective To investigate the expression of Ang-1 and Ang-2 in endometrial tissue of patients with abnormal uterine bleeding after medical abortion, and to explore the relationship between Ang-1 and abnormal uterine bleeding. Methods A total of 1087 cases of abnormal uterine bleeding after medical abortion were diagnosed by pathological examination. 40 cases of abnormal bleeding were selected and 20 cases of abortion without abnormal bleeding were used as control. Immunohistochemistry was used to detect the uterus The difference of the positive expression rate and expression intensity of Ang-1 and Ang-2 in endometrium. Results 1.1087 cases of villi and decidua accounted for 80.5%; 2. Ang-1, Ang-2 protein in the endometrial tissue after medical abortion, glandular epithelial cells and endometrial stromal cells and vascular wall expression, The expression of Ang-1 and Ang-2 in the two groups were all 100%, but the expression of Ang-1 and Ang-2 in the group of abnormal bleeding were higher than that in the control group, the difference was significant (P <0.01). Conclusions The residual villi and decidua after medical abortion may be the main reason leading to prolonged bleeding time and bleeding volume. The increased expression of angiopoietin in endometrium of patients with abnormal uterine bleeding after medical abortion may cause angiogenesis abnormalities So that villus and decidua do not fall off easily or endometrial repair affected, resulting in an extension of the bleeding time.