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重度妊娠高血压综合征患者子宫胎盘病理变化及其临床意义

更新时间:2012-04-21 13:23:36  
李翠兰 胡章和 唐齐华

  【摘要】 目的 探讨重度妊娠高血压综合征(妊高征)患者子宫胎盘病理变化及其对孕产妇和围产儿结局的影响。方法 选择正常晚孕妇女(对照组)和重度妊高征患者(观察组)各117例,常规HE染色观察胎盘形态学变化,并对两组孕妇进行血液分析、生化检查及肝肾功能检查。结果 观察组胎盘重量明显减轻,细胞滋养细胞增殖,合体滋养细胞结节增多,基底膜增厚,基质纤维素样坏死,绒毛间隙水肿,绒毛内血管数目减少、淤血严重等,蜕膜内血管生理性改变消失,与对照组上述各指标比较,差异均有极显著性(P<0.01);观察组合并严重贫血、重度血小板减少症、血液高粘度、低蛋白血症、大量腹水、眼底动脉痉挛性改变等多于对照组,差异具有极显著性(P<0.01)。结论 重度妊高征患者胎盘形态学病理变化明显,且与病情严重程度呈平行关系。
  【关键词】 妊娠并发症,心血管; 高血压; 胎盘; 妊娠结局

Clinical Study on Morphological Characteristics of Placenta in Severe Pregnancy Induced Hypertension

LI Cuilan, HU Zhanghe, TANG Qihua
(Department of Obstetrics and Gynecology, First Affiliated Hospital, Hubei Medical University, Wuhan 430060,China)

 【Abstract】 Objective To study morphological characteristics of placenta in severe pregnancy induced hypertension (SPIH) and its relationship to pregnant outcome. Methods Morphological changes were observed by light microscopy; Blood biochemical analyses were used to predispose pregnant outcome. Results Difference in pathological changes of placental bed between normal term pregnancy (NTP) and SPIH groups was significant: the placental weight, proliferation of cytotrophoblasts, numbers of the placental villi with syncytial knots, thickness of basal lamina, fibrinoid necrosis and deposition of matrix, stromal edema and fibrosis of villi, the vascular numbers of villi, stasis; lack of physiologic changes in decidual spiral arteries. Clinical examination showed that the rate of anemia, thrombocytopenia, blood concentration, hypoproteinemia, ascites, eye ground artery spasm in SPIH were higher in NIT. Conclusions Pathological changes of placenta play important roles in development of SPIH, and the pathological changes are paralleled with the severity of the disease.
  【Key words】 Pregnancy complications, cardiovascular; Hypertension;  Placenta;  Pregnancy outcome

  妊娠高血压综合征(妊高征)是伴随着妊娠出现并加重的、以高血压为主要临床表现的一系列症候群。一般轻、中度妊高征对孕产妇及围产儿的影响较易控制,但重度

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