摘要
目的观察妊娠期糖尿病(GDM)并发巨大儿产妇胎盘超微结构及相关参数的变化。方法选取行剖宫产产妇的胎盘组织40例进行研究,其中GDM并发巨大儿产妇及正常足月巨大儿产妇的胎盘组织各15例(分别为GDM并发巨大儿组、正常巨大儿组),正常胎盘组织(对照组)10例。胎盘娩出2 h内,对胎盘进行大体检查,检测胎盘质量、胎盘系数及胎盘容积;随后,在透射式电子显微镜下观察胎盘超微结构,记录胎盘电镜下微绒毛体视学参数,包括密度参数(体积密度、表面积密度)、分布参数、形状参数、合体细胞基底膜平均厚度、毛细血管基底膜平均厚度。结果GDM并发巨大儿组的胎盘质量、胎盘容积及胎盘系数均大于正常巨大儿组与对照组,且正常巨大儿组的胎盘质量、胎盘容积及胎盘系数大于对照组(P均<0.05)。GDM并发巨大儿组胎盘合体滋养细胞微绒毛排列絮乱,分布不均,细胞质内线粒体肿胀;GDM并发巨大儿组胎盘超微结构改变比例高于正常巨大儿组与对照组,且正常巨大儿组高于对照组(P均<0.05)。GDM并发巨大儿组胎盘微绒毛体积密度、表面积密度、形状参数均低于正常巨大儿组与对照组,分布参数、合体细胞基底膜平均厚度、毛细血管基底膜平均厚度高于正常巨大儿组与对照组(P均<0.05);正常巨大儿组体积密度、表面积密度、形状参数均低于对照组,分布参数、合体细胞基底膜平均厚度、毛细血管基底膜平均厚度高于对照组(P均<0.05)。结论GDM并发巨大儿产妇胎盘质量、胎盘容积及胎盘系数增大,胎盘微绒毛形态学发生明显改变,胎盘微绒毛密度参数和形状参数降低,分布参数、合体细胞基底膜平均厚度、毛细血管基底膜平均厚度增高,从而影响胎盘的供氧与供血功能。
Objective To observe the ultrastructural changes of placenta and related parameters of pregnant women with gestational diabetes mellitus(GDM)complicated with macrosomia.Methods Forty cases of placental tissues of pregnant women undergoing cesarean section were selected for study,including 15 cases of GDM complicated with macrosomia and 15 cases of normal full-term macrosomia(GDM complicated with macrosomia group,and normal macrosomia group)and 10 cases of normal placental tissues(control group).After the placenta was delivered within 2 h,the placenta was examined in general to detect its weight,placental coefficient and placental volume;then,the ultrastructure of the placenta was observed under the transmission electron microscope,and the visual parameters of the microvilli under the electron microscope were recorded,including density parameters(volume density,surface density),distribution parameters,shape parameters,mean thickness of the basement membrane of the syncytial cells,and mean thickness of the basement membrane of the capillaries.Results The placental weight,placental volume and placental coefficient of the GDM complicated with macrosomia group were all higher than those of the normal macrosomia group and the control group,and the placental weight,placental volume and placental coefficient of the normal macrosomia group were greater than those of the control group(all P<0.05).The microvilli of placental syncytiotrophoblast cells in the GDM complicated with macrosomia group were disorderly arranged and unevenly distributed,and the mitochondria in the cytoplasm were swollen.The proportion of placental ultrastructure change in the GDM complicated with macrosomia group was higher than that in the normal macrosomia group and control group,and the proportion of normal macrosomia group was higher than that in the control group(all P<0.05).The volume density,surface area density,and shape parameters of the placental microvilli of the GDM complicated with macrosomia group were all lower than those of the normal macrosomia and control groups,and the distribution parameters,average thickness of the basement membrane of the syncytial cells,and average thickness of the basement membrane of the capillaries were higher than those of the normal macrosomia and control groups(all P<0.05).The volume density,surface area density and shape parameters of the normal macrosomia group were all lower than those of the control group,and the distribution parameters,average thickness of the basement membrane of the syncytial cells and the average thickness of the basement membrane of the capillaries were higher than those of the control group(all P<0.05).Conclusion The placental weight,placental volume and placental coefficient of pregnant women with GDM complicated with macrosomia increase,the morphology of the placental microvilli is significantly changed,the density and shape parameters of the placental microvilli decrease,the distribution parameters,the average thickness of the basement membrane of the syncytial cells and the average thickness of the basement membrane of the capillaries increase;these changes may affect the placental feeding and blood supply function.
作者
赵娜
米阳
宋妙妙
ZHAO Na;MI Yang;SONG Miaomiao(Xi′an Medical University,Xi′an 710000,China;不详)
出处
《山东医药》
CAS
2020年第32期5-8,共4页
Shandong Medical Journal
关键词
妊娠期糖尿病
巨大儿
胎盘
超微结构
gestational diabetes mellitus
macrosomia
placenta
ultrastructure
